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

Title:	10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial.
Authors:	Halliday A; Harrison M; Hayter E; Kong X; Mansfield A; Marro J; Pan H; Peto R; Potter J; Rahimi K; Rau A; Robertson S; Streifler J; Thomas D; Asymptomatic Carotid Surgery Trial Collaborative G.r.o.u.p. Fraedrich G; Schmidauer C; Hölzenbein TH; Huk I; Haumer M; Kretschmer G; Metz V; Polterauer P; Teufelsbauer H; Cras P; Hendriks J; Lauwers P; Van Schil P; de Souza EB; Dourado ME; Gurgel G; Rocha GM; Petrov V; Slabakov G; Cooper ME; Gubitz G; Holness R; Howes W; Langille R; Legg K; Nearing S; MacKean G; MacKay M; Phillips SJ; Sullivan J; Wood J; Erdelez L; Sosa T; Angelides NS; Christopoulos G; Malikidou A; Pesta A; Ambler Z; Mracek J; Polivka J; Rohan V; Sevcik P; Simaná J; Benes V; Kramár F; Kaste M; Lepäntalo M; Soinne L; Cardon JM; Legalou A; Gengenbach B; Pfadenhauer K; Wölfl KD; Flessenkämper I; Klumpp BF; Marsch J; Kolvenbach R; Pfeiff T; Sandmann W; Beyersdorf F; Hetzel A; Sarai K; Schöllhorn J; Spillner G; Lutz HJ; Böckler D; Maeder N; Busse O; Grönniger J; Haukamp F; Balzer K; Knoob HG; Roedig G; Virreira L; Franke S; Moll R; Schneider J; Dayantas J; Sechas MN; Tsiaza S; Kiskinis D; Apor A; Dzinich C; Entz L; Hüttl K; Jàrànyi Z; Mogan I; Nagy Z; Szabo A; Varga D; Juhász G; Mátyás L; Hutchinson M; Mehigan D; Aladjem Z; Harah E; Elmakias S; Gurvich D; Yoffe B; Ben Meir H; Dagan L; Karmeli R; Keren G; Shimony A; Weller B; Avrahami R; Koren R; Streifler JY; Tabachnik S; Zelikovski A; Angiletta D; Federico F; Impedovo G; Marotta V; Pascazio L; Regina G; Andreoli A; Pozzati E; Bonardelli S; Giulini SM; Guarneri B; Caiazzo P; Mascoli F; Becchi G; Masini R; Santoro E; Simoni G; Ventura M; Scarpelli P; Spartera C; Arena O; Collice M; Puttini M; Romani F; Santilli I; Segramora V; Sterzi R; Deriu G; Verlato F; Cao PG; CIERI, ENRICO; De Rango P; Moggi L; Ricci S; Antico A; Spigonardo F; Malferrari G; Tusini N; Vecchiati E; Cavallaro A; Kasemi H; Marino M; Sbarigia E; Speziale F; Zinicola N; Alò FP; Bartolini M; Carbonari L; Caporelli S; Grili Cicilioni C; Lagalla G; Ioannidis G; Pagliariccio G; Silvestrini M; Palombo D; Peinetti F; Adovasio R; Chiodo Grandi F; Mase G; Zamolo F; Fregonese V; Gonano N; Mozzon L; Blair R; Chuen J; Ferrar D; Garbowski M; Hamilton MJ; Holdaway C; Muthu S; Shakibaie F; Vasudevan TM; Kroese A; Slagsvold CE; Dahl T; Johnsen HJ; Lange C; Myhre HO; Gniadek J; Andziak P; Elwertowski M; Leszczynski J; Malek AK; Mieszkowski J; Noszczyk W; Szostek M; Toutounchi S; Correia C; Pereira MC; Akchurin RS; Flis V; Miksic K; Stirn B; Tetickovic E; Cairols M; Capdevila JM; Iborra Ortega E; Obach V; Riambau V; Vidal Barraquer F; Vila Coll R; Diaz Vidal E; Iglesias Negreia JI; Tovar Pardo A; Iglesias RJ; Alfageme AF; Barba Velez A; Estallo Laliena L; Garcia Monco JC; Gonzalez LR; Corominas C; Julia J; Lozano P; Marti Masso JF; Porta RM; Carrera AR; Gomez J; Blomstrand C; Gelin J; Holm J; Karlström L; Mattsson E; Bornhov S; Dahlstrom J; De Pedis G; Jensen SM; Pärsson H; Plate G; Qvarfordt P; Arvidsson B; Brattström L; Forssell C; Potemkowski A; Skiöldebrand C; Stoor P; Blomqvist M; Calander M; Lundgren F; Almqvist H; Norgren L; Norrving B; Ribbe E; Thörne J; Gottsäter A; Mätzsch T; Nilsson ME; Lonsson M; Stahre B; Stenberg B; Konrad P; Jarl L; Lundqvist L; Olofsson P; Rosfors S; Swedenborg J; Takolander R; Bergqvist D; Ljungman C; Kniemeyer HW; Widmer MK; Kuster R; Kaiser R; Nagel W; Sege D; Weder B; De Nie J; Doelman J; Yilmaz N; Buth J; Stultiens G; Boiten J; Boon A; van der Linden F; Busman DC; Sinnige HA; Yo TI; de Borst GJ; Eikelboom BC; Kappelle LJ; Moll F; Dortland RW; Westra TE; Jaber H; Manaa J; Meftah RB; Nabil BR; Sraieb T; Bateman D; Budd J; Horrocks M; Kivela M; Shaw L; Walker R; D'Sa AA; Fullerton K; Hannon R; Hood JM; Lee B; McGuigan K; Morrow J; Reid J; Soong CV; Simms M; Baird R; Campbell M; Cole S; Ferguson IT; Lamont P; Mitchell D; Sassano A; Smith FC; Blake K; Kirkpatrick PJ; Martin P; Turner C; Clegg JF; Crosley M; Hall J; De Cossart L; Edwards P; Fletcher D; Rosser S; McCollum PT; Davidson D; Levison R; Bradbury AW; Chalmers RT; Dennis M; Murie J; Ruckley CV; Sandercock P; Campbell WB; Frankel T; Gardner Thorpe C; Gutowski N; Hardie R; Honan W; Niblett P; Peters A; Ridler B; Thompson JF; Bone I; Welch G; Grocott EC; Overstall P; Aldoori MI; Dafalla BE; Bryce J; Clarke C; Ming A; Wilkinson AR; Bamford J; Berridge D; Scott J; Abbott RJ; Naylor R; Harris P; Humphrey P; Adiseshiah M; Aukett M; Baker D; Bishop CC; Boutin A; Brown M; Burke P; Burnand KG; Colchester A; Coward L; Davies AH; Espasandin M; Giddings AE; Hamilton G; Judge C; Kakkos S; McGuiness C; Morris Vincent P; Nicolaides A; Padayachee TS; Riordan H; Sullivan E; Taylor P; Thompson M; Wolfe JH; McCollum CN; O'Neill PA; Welsh S; Barnes J; Cleland P; Davis M; Gholkar A; Jones R; Jaykishnam V; Mendelow AD; O'Connell JE; Siddique MS; Stansby G; Vivar R; Ashley S; Cosgrove C; Gibson J; Wilkins DC; Chant AD; Frankel J; Shearman CP; Williams J; Hall G; Holdsworth R; Davies JN; McLean B; Woodburn KR; Brown G; Curley P; Loizou L; Chaturvedi S; Diaz F; Radak D; Todorovic PR; Kamugasha D; Baxter A; Berry C; Burrett J; Collins R; Crowther J; Davies C; Farrell B; Godwin J; Gray R; Harwood C; Hirt L; Hope C; Knight S; Lay M; Munday A; Murawska A; Peto CG; Radley A; Richards S.
Contributors:	Halliday, A; Harrison, M; Hayter, E; Kong, X; Mansfield, A; Marro, J; Pan, H; Peto, R; Potter, J; Rahimi, K; Rau, A; Robertson, S; Streifler, J; Thomas, D; Fraedrich G, Asymptomatic Carotid Surgery Trial Collaborative G. r. o. u. p.; Schmidauer, C; Hölzenbein, Th; Huk, I; Haumer, M; Kretschmer, G; Metz, V; Polterauer, P; Teufelsbauer, H; Cras, P; Hendriks, J; Lauwers, P; Van Schil, P; de Souza, Eb; Dourado, Me; Gurgel, G; Rocha, Gm; Petrov, V; Slabakov, G; Cooper, Me; Gubitz, G; Holness, R; Howes, W; Langille, R; Legg, K; Nearing, S; Mackean, G; Mackay, M; Phillips, Sj; Sullivan, J; Wood, J; Erdelez, L; Sosa, T; Angelides, N; Christopoulos, G; Malikidou, A; Pesta, A; Ambler, Z; Mracek, J; Polivka, J; Rohan, V; Sevcik, P; Simaná, J; Benes, V; Kramár, F; Kaste, M; Lepäntalo, M; Soinne, L; Cardon, Jm; Legalou, A; Gengenbach, B; Pfadenhauer, K; Wölfl, Kd; Flessenkämper, I; Klumpp, Bf; Marsch, J; Kolvenbach, R; Pfeiff, T; Sandmann, W; Beyersdorf, F; Hetzel, A; Sarai, K; Schöllhorn, J; Spillner, G; Lutz, Hj; Böckler, D; Maeder, N; Busse, O; Grönniger, J; Haukamp, F; Balzer, K; Knoob, Hg; Roedig, G; Virreira, L; Franke, S; Moll, R; Schneider, J; Dayantas, J; Sechas, Mn; Tsiaza, S; Kiskinis, D; Apor, A; Dzinich, C; Entz, L; Hüttl, K; Jàrànyi, Z
Publication Year:	2010
Collection:	IRIS Università degli Studi di Perugia
Subject Terms:	Carotid Stenosis \| Internal Carotid Artery \| Endarterectomy
Description:	BACKGROUND: 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. METHODS: 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. FINDINGS: 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7% versus 4·8% at 1 year (and 92·1%vs 16·5% at 5 years). Perioperative risk of stroke or death within 30 days was 3·0% (95% CI 2·4-3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1% versus 10·0% at 5 years (gain 5·9%, 95% CI 4·0-7·8) and 10·8% versus 16·9% at 10 years (gain 6·1%, 2·7-9·4); ratio of stroke incidence rates 0·54, 95% CI 0·43-0·68, p
Document Type:	article in journal/newspaper
File Description:	STAMPA
Language:	English, Middle (1100-1500)
Relation:	info:eu-repo/semantics/altIdentifier/wos/WOS:000282411600034; volume:376(9746)/2010; firstpage:1074; lastpage:1084; numberofpages:11; journal:THE LANCET; https://hdl.handle.net/11391/872898
DOI:	10.1016/S0140-6736(10)61197-X
Availability:	https://hdl.handle.net/11391/872898; https://doi.org/10.1016/S0140-6736(10)61197-X; https://www-sciencedirect-com.ezproxy.unibo.it/science/article/pii/S014067361061197X?via=ihub
Accession Number:	edsbas.8DF03DE1
Database:	BASE