Key result
An occluded contralateral artery increased the 2-year risk of ipsilateral stroke in medically treated patients with severe ipsilateral stenosis compared to mild-to-moderate stenosis (HR 2.65; 95% CI 1.43-4.90).
Why the study?
Does carotid endarterectomy reduce ipsilateral stroke compared to medical therapy in patients with symptomatic severe carotid stenosis and contralateral carotid disease?
Population
659 patients who presented with a recent ischemic event referable to a 70% to 99% stenosis of one carotid…
Comparison
Carotid endarterectomy on the recently… vs Medical treatment
Design
RCT
Follow-up
2 years
Authors
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Favors CEA over medical therapy alone for symptomatic severe stenosis with contralateral occlusion; extends prior RCTs to this high-risk anatomy.
Cohort (n=659)
Does carotid endarterectomy reduce ipsilateral stroke compared to medical therapy in patients with symptomatic severe carotid stenosis and contralateral carotid disease?
Effect estimate: HR 2.65 (95% CI 1.43-4.90)
Carotid endarterectomy provides considerable long-term benefit over medical therapy for patients with symptomatic severe ipsilateral carotid stenosis, even when complicated by an occluded contralateral artery.
Gasecki et al. (1995) conducted a cohort in Symptomatic severe carotid stenosis with contralateral carotid stenosis or occlusion (n=659). Carotid endarterectomy vs. Medical treatment was evaluated on Ipsilateral stroke at 2 years (HR 2.65, 95% CI 1.43-4.90). An occluded contralateral artery increased the 2-year risk of ipsilateral stroke in medically treated patients with severe ipsilateral stenosis compared to mild-to-moderate stenosis (HR 2.65; 95% CI 1.43-4.90).
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