10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial

A. Halliday, M. Harrison, E. Hayter, X. Kong, A. Mansfield, J. Marro, H. Pan, R. Peto, Jon Godwin

Research output: Contribution to journalArticle

Abstract

If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3—2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6—11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392.

Original languageEnglish
Pages (from-to)1074-1084
Number of pages11
JournalLancet
Volume376
Issue number25
DOIs
Publication statusPublished - 1 Sep 2010

Keywords

  • clinical trial
  • carotid surgery
  • stroke prevention

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