Status update and interim results from the asymptomatic carotid surgery trial-2 (ACST-2)

OBJECTIVES: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. METHODS: Patients are entered into ACST-2 when revascularization is felt to b...

Full description

Saved in:
Bibliographic Details
Main Authors: Kollaboráció szervezet: ACST-2 Collaborative Group
Nemes Balázs
Járányi Zsuzsanna
Szabó A.
Varga D.
Barzó Pál
Bodosi Mihály
Fakó E.
Fülöp Béla
Kuncz E.
Nagy Endre
Németh T.
Pazdernyik S.
Skoba K.
Vörös Erika, Sarolta
Format: Article
Published: 2013
Series:EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 46 No. 5
Subjects:
doi:10.1016/j.ejvs.2013.07.020

mtmt:3270428
Online Access:http://publicatio.bibl.u-szeged.hu/22627
LEADER 03054nab a2200385 i 4500
001 publ22627
005 20211012083222.0
008 211012s2013 hu o 0|| Angol d
022 |a 1078-5884 
024 7 |a 10.1016/j.ejvs.2013.07.020  |2 doi 
024 7 |a 3270428  |2 mtmt 
040 |a SZTE Publicatio Repozitórium  |b hun 
041 |a Angol 
100 2 |a Kollaboráció szervezet: ACST-2 Collaborative Group 
245 1 0 |a Status update and interim results from the asymptomatic carotid surgery trial-2 (ACST-2)  |h [elektronikus dokumentum] /  |c  Kollaboráció szervezet: ACST-2 Collaborative Group 
260 |c 2013 
300 |a 510-518 
490 0 |a EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY  |v 46 No. 5 
520 3 |a OBJECTIVES: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. METHODS: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. RESULTS: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD +/- 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. CONCLUSIONS: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. CLINICAL TRIAL: ISRCTN21144362. 
650 4 |a Klinikai orvostan 
700 0 1 |a Nemes Balázs  |e aut 
700 0 1 |a Járányi Zsuzsanna  |e aut 
700 0 1 |a Szabó A.  |e aut 
700 0 1 |a Varga D.  |e aut 
700 0 1 |a Barzó Pál  |e aut 
700 0 1 |a Bodosi Mihály  |e aut 
700 0 1 |a Fakó E.  |e aut 
700 0 1 |a Fülöp Béla  |e aut 
700 0 1 |a Kuncz E.  |e aut 
700 0 1 |a Nagy Endre  |e aut 
700 0 1 |a Németh T.  |e aut 
700 0 1 |a Pazdernyik S.  |e aut 
700 0 1 |a Skoba K.  |e aut 
700 0 1 |a Vörös Erika, Sarolta  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/22627/1/32704281-s2.0-S1078588413005029-main.pdf  |z Dokumentum-elérés