Carotid endarterectomy | carotid stenosis, in asymptomatic patients | vs control | NS | by 31% | by 30% | by 549% | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
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stroke or death | 0.89 [0.78 1.01] | p=1.00 | 0 | 5223 | 3 | ACAS, ACST, VA, | Perioperative stroke or death or any subsequent stroke | 0.69 [0.56 0.84] | p=0.04 | 0 | 5223 | 3 | ACAS, ACST, VA, | Perioperative stroke or death or subsequent ipsilateral stroke | 0.70 [0.54 0.91] | p=0.04 | 0 | 5223 | 3 | ACAS, ACST, VA, | Perioperative stroke or death | 6.49 [2.51 16.77] | p=0.04 | 0 | 2103 | 2 | ACAS, VA, | TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients Trial | Studied treatment | Control | Patients |
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ACAS, 1995 | carotid endarterectomy, aspirin 325 mg daily | aspirin 325 mg daily | Asymptomatic carotid artery stenosis of 60% or greater | ACST, 1994 | CEA as soon as possible, standard medical treatment including antiplatelet drugs | no CEA unless symptoms occurred, standard medical treatment including antiplatelet
drugs | Asymptomatic carotid artery stenosis of 60% or greater | VA, 1993 | carotid endarterectomy aspirin 650 mg bd | aspirin 650 mg bd | Asymptomatic carotid artery stenosis of 50-99% |
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Carotid endarterectomy | carotid stenosis, in symptomatic patients | vs control | - | - | - | - | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
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stroke or death | no data | Perioperative stroke or death or any subsequent stroke | no data | Perioperative stroke or death or subsequent ipsilateral stroke | no data | Perioperative stroke or death | no data | TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients Trial | Studied treatment | Control | Patients |
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ECST, 1998 | surgery | control | men and women of any age, with some degree of carotid stenosis, who within the previous 6 months had had at least one transient or mild symptomatic ischaemic vascular event in the distribution of one or both carotid arteries | NASCET, 1998 | carotid endarterectomy | medical care alone | Patients with moderate (<70%) carotid stenosis and transient ischemic attacks or nondisabling strokes on the same side as the stenosis (ipsilateral) within 180 days | VA309, 1991 | Carotid endarterectomy plus the best medical care | best medical care alone | Men who presented within 120 days of onset of symptoms that were consistent with transient ischemic attacks, transient monocular blindness, or recent small completed strokes and with with angiographic internal carotid artery stenosis greater than 50% ipsilateral to the presenting symptoms |
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