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Randomized Trial of Stent versus Surgery for Asymptomatic Carotid Stenosis

Thursday, February 18, 2016

Submitted by

Mark Ferguson

Source

Source Name: New England Journal of Medicine

Source URL: http://www.nejm.org/doi/full/10.1056/NEJMoa1515706?query=featured_home

Author(s)

Kenneth Rosenfield, Jon S. Matsumura, Seemant Chaturvedi, Tom Riles, Gary M. Ansel, D. Chris Metzger, Lawrence Wechsler, Michael R. Jaff, and William Gray for the ACT I Investigators

Over 1400 patients with asymptomatic severe carotid stenosis were randomized to with carotid stenting or endarterectomy. The endpoints were the composite of death, stroke, or acute MI within 30 days, or ipsilateral stroke. Stenting was non-inferior to endarterectomy. The rate of the composite endpoint was 3.8% vs 3.4% (stent vs surgery). At 30 days to 5 years, freedom from ipsilateral stroke was 97.8% vs 97.3%. Cumulative stroke-free survival rates were 93.1% and 94.7%.