Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

P. Cras, J. M H Hendriks, P. Lauwers, M. Hertoghs, P. Van Schil, L. De Jaegher, P. Peeters, J. Verbist, D. Dendooven, J. De Letter, G. Vanhooren, P. Astarci, I. Capron, C. Choghari, F. Hammer, V. Lacroix, A. Peeters, R. Verhelst, M. Bosiers, K. De MeesterK. Deloose, E. Van Buggenhout, E. Vinck, M. Geenens, D. Hemelsoet, I. Van Herzeele, F. Vermassen, G. De Koster, Q. Desiron, A. Maertens De Noordhout, D. Malmendier, M. Massoz, G. Saad, S. Cirelli, P. Dormal, P. Lerut, E. Thues, S. Coutts, A. Demchuk, M. Hill, M. Hudon, G. Klein, M. McClelland, W. Morrish, G. Samis, G. Sutherland, T. Watson, J. Wong, Bao Liu, Chang Wei Liu, L. Barankova, V. Chlouba, J. Fiedler, V. Priban, L. Sterba, L. Kalabova, Z. Kriz, P. Krupa, M. Privara, M. Reif, L. Souckova, R. Staffa, R. Vlachovsky, B. Vojtisek, T. Hrbac, M. Kuliha, V. Prochazka, M. Roubec, D. Skoloudik, F. Abd Allah, M. H. Eldessoki, H. Heshmat Kassem, H. Soliman Gharieb, J. M. Cardon, A. Le Gallou Wittenberg, E. Allaire, J. P. Becquemin, F. Cochennec, P. Desgranges, H. Hosseini, H. Kobeiter, J. Marzelle, P. Bergeron, R. Padovani, J. C. Trastour, B. Biermaier, H. M. Gissler, C. Klotzsch, T. Pfeiffer, R. Schneider, L. Soehl, M. Wennrih, Y. Bausback, S. Botsios, D. Branzan, S. Braunlich, H. Holzer, J. Lenzer, C. Reichenbecher, C. Piorkowski, J. Schuster, D. Scheinert, A. Schmidt, M. Ulrich, M. Werner, A. Coster, A. Engelhardt, C. M. Ratusinski, B. Berekoven, K. Frerker, V. Gordon, G. Torsello, I. Bellenis, A. Polydorou, V. Polydorou, A. Tavernarakis, N. Ioannou, M. Terzoudi, E. Chatzinikou, A. Giannoukas, G. Hadjigeorgiou, S. Koutsias, S. Ralli, N. Rousas, B. Nemes, Z. Jàrànyi, A. Szabo, D. Varga, P. Barzo, M. Bodosi, E. Fako, B. Fulop, A. Kuncz, E. Nagy, T. Nemeth, S. Pazdernyik, K. Skoba, E. Voros, S. N. Haider, J. Harbison, P. Madhavan, D. Moore, R. Beyar, A. Hoffman, T. Karram, A. Kerner, E. Nikolsky, S. Nitecki, G. Amatucci, P. Vittorio, [No Value] Frederico, D. Marinazzo, G. Regina, A. Giaquinta, F. Patti, M. Veroux, P. Veroux, L. Adobbati, G. Bertoni, P. Bianchi, R. Casana, L. Cireni, L. Martello, V. Tolva, L. Arcuri, F. Casoni, G. Coppi, R. Moratto, J. Veronesi, G. Bajardi, G. Savettieri, R. Corbetta, A. Odero, P. Quaretti, Z. Thyrion, P. Cao, V. Caso, P. DeRango, L. Farchioni, G. Parlani, G. Malferrari, F. Strozzi, N. Tusini, E. Vecchiati, A. Biello, L. Capoccia, D. Menna, A. Rita Rizzo, E. Sbarigia, F. Speziale, D. Toni, M. Giovanni, G. Meola, G. Nano, M. T. Occiuto, S. Stegher, D. Tealdi, F. Accrocca, C. Ambrogi, R. Barbazza, G. Marcucci, A. Cappelli, G. De Donato, G. Palasciano, D. Pieragalli, C. Setacci, F. Settaci, C. Labate, E. Ferrero, M. Ferri, F. Nessi, A. Viazzo, P. Castelli, M. L. Delodovici, M. Ferrario, G. Piffaretti, G. Tomei, E. Furui, T. Inoue, R. Kondo, Y. Matsumoto, H. Shimizu, B. Aidashova, N. Kospanov, R. Lyssenko, D. Mussagaliev, G. J. De Borst, A. G. Den Hartog, R. Lo, F. Moll, R. Toorop, H. B. Van Der Worp, E. J. Vonken, S. Bakke, K. Krohg-Sorensen, M. Skjelland, P. Andziak, S. Drelichowski, M. Dratwicki, R. Gil, W. Iwanowski, K. Koncewicz, M. Nowicki, J. Pniewski, J. Rzezak, P. Seweryniak, P. Bialek, Z. Biejat, W. Czepel, A. Czlonkowska, A. Dowzenko, J. Jedzrejewska, A. Kobayashi, J. Leszezyuski, A. Malek, J. Polanski, R. Proczka, M. Skorski, M. Szostek, N. Aleksic, S. Babic, J. Kolar, D. Radak, D. Sagic, S. Tanaskovic, M. Colic, L. Davidovic, D. Jovanovic, I. Koncar, D. Bartko, P. Beno, F. Rusnak, K. Zelenak, M. Gasparini, A. Grad, I. Kompara, Z. Milosevic, V. Flis, J. Matela, K. Miksic, F. Milotic, B. Mrdja, B. Stirn, E. Tetickovic, A. Chamorro, V. Obach, V. Riambau, S. Roman, E. Blanco, A. Y. Izquierdo, M. Guerra, E. Campbell, H. Lindgren, J. Nyberg, G. Plate, H. Parsson, P. Qvarfordt, S. Acosta, K. Bjorses, K. Brandt, N. Dias, A. Gottsater, J. Holst, T. Kristmundsson, T. Kuhme, T. Kolbel, B. Lindblad, M. Lindh, M. Malina, T. Ohrlander, T. Resch, V. Rönnle, B. Sonesson, M. Warvsten, Z. Zdanowski, B. Bengt, M. Delle, J. Formgren, P. Gillgren, L. Jarl, T. B. Kall, P. Konrad, N. Nyman, C. Skioldebrand, J. Steuer, R. Takolander, F. J. Ahlhelm, L. Bonati, S. S. Engelter, T. Eugster, H. Gensicke, P. Lyrer, L. Mariani, P. Stierli, C. Stippich, T. Wolff, A. Mehrzad, E. Brown, B. Esisi, N. Butler, D. J. Day, P. Hayes, N. Higgins, E. Jumilla, P. Martin, J. Mitchell, K. Varty, A. Birt, P. Davies, J. George, A. Graham, L. Jonker, T. Joseph, N. Kelsall, C. Potts, T. Wilson, P. Davey, R. Hayman, G. Tervitt, A. Abdul-Hamiq, J. Bryce, I. Chetter, D. Ettles, R. Lakshminarayan, K. Mitchelsonm, C. Rhymes, G. Robinson, P. Scott, A. Vickers, H. Baht, I. Balogun, I. Burger, L. Cowie, G. Gunathilagan, D. Hargroves, R. Insall, S. Jones, H. Rudenko, J. Senaratne, G. Thomas, A. Thomson, P. Enevoldson, H. Nahser, I. O'Brian, F. Torella, D. Watling, R. White, A. Clifton, C. Eley, N. Khanom, J. O'Reilly, A. Pereira, C. Bicknell, N. Cheshire, R. Gibbs, M. Hamady, A. James, M. Jenkins, A. Lacey, M. Mireskandari, T. Sachs, J. Wolfe, D. Hardy, F. Justin, L. Phiri, L. Sekaran, S. Sethuraman, L. Tate, J. Akyea-Mensah, A. Chrisopoulou, J. V. Smyth, I. Nichol, A. Parry, G. Young, M. Clarke, M. Davis, A. Dixit, A. Dyker, G. Ford, R. Jackson, S. Kappadath, D. Lambert, T. Lees, S. Louw, S. Macdonald, N. Parr, G. Stansby, L. Wales, V. Wealleans, L. Wilson, M. Wyatt, P. Dorman, A. Hughes, D. Jones, A. D. Mendelow, H. Rodgers, S. MacSweeney, N. McConachie, A. Southam, W. Sunman, D. Briley, C. Darby, A. Handa, L. Hands, W. Kuker, K. Michael, J. Perkins, U. Schulz, D. Smith, R. Teal, M. Donnelly, S. D'Souza, A. Asehosem Egun, B. Gregory, C. Kelly, S. Punekar, S. Raj, D. Seriki, G. Thomson, J. Beard, T. Cleveland, J. Humphreys, A. Jenkins, C. King, R. Lonsdale, R. Nair, S. Nawaz, F. Okhuoya, D. Turner, G. Venables, J. Brown, R. Durairajan, P. Guyler, P. Harman, M. Jakeways, C. Khuoge, A. Kundu, T. Loganathan, D. Sinha, V. Thompson, S. Tysoe, [No Value] Barer, A. Brown, S. Crawford, P. Dunlop, [No Value] Majmudar, D. Mitchell, [No Value] O'Brien, [No Value] O'Connell, [No Value] Scott, S. Vetrivel, R. Ashleigh, S. Butterfield, G. Gamble, J. Ghosh, C. McCollum, M. Welch, S. Welsh, V. Kazan, M. Nazzal, V. Ramsey-Williams

Research output: Contribution to journalArticle

Abstract

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362.

Original languageEnglish (US)
Pages (from-to)510-518
Number of pages9
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume46
Issue number5
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Carotid Endarterectomy
Carotid Arteries
Pathologic Constriction
Stroke
Morbidity
Mortality
Carotid Stenosis
Uncertainty
Myocardial Infarction
Clinical Trials
Equipment and Supplies
Therapeutics

Keywords

  • Carotid artery stenosis
  • Carotid artery stenting
  • Carotid endarterectomy
  • Randomized controlled trial
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Cras, P., Hendriks, J. M. H., Lauwers, P., Hertoghs, M., Van Schil, P., De Jaegher, L., ... Ramsey-Williams, V. (2013). Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2). European Journal of Vascular and Endovascular Surgery, 46(5), 510-518. https://doi.org/10.1016/j.ejvs.2013.07.020

Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2). / Cras, P.; Hendriks, J. M H; Lauwers, P.; Hertoghs, M.; Van Schil, P.; De Jaegher, L.; Peeters, P.; Verbist, J.; Dendooven, D.; De Letter, J.; Vanhooren, G.; Astarci, P.; Capron, I.; Choghari, C.; Hammer, F.; Lacroix, V.; Peeters, A.; Verhelst, R.; Bosiers, M.; De Meester, K.; Deloose, K.; Van Buggenhout, E.; Vinck, E.; Geenens, M.; Hemelsoet, D.; Van Herzeele, I.; Vermassen, F.; De Koster, G.; Desiron, Q.; Maertens De Noordhout, A.; Malmendier, D.; Massoz, M.; Saad, G.; Cirelli, S.; Dormal, P.; Lerut, P.; Thues, E.; Coutts, S.; Demchuk, A.; Hill, M.; Hudon, M.; Klein, G.; McClelland, M.; Morrish, W.; Samis, G.; Sutherland, G.; Watson, T.; Wong, J.; Liu, Bao; Liu, Chang Wei; Barankova, L.; Chlouba, V.; Fiedler, J.; Priban, V.; Sterba, L.; Kalabova, L.; Kriz, Z.; Krupa, P.; Privara, M.; Reif, M.; Souckova, L.; Staffa, R.; Vlachovsky, R.; Vojtisek, B.; Hrbac, T.; Kuliha, M.; Prochazka, V.; Roubec, M.; Skoloudik, D.; Abd Allah, F.; Eldessoki, M. H.; Heshmat Kassem, H.; Soliman Gharieb, H.; Cardon, J. M.; Le Gallou Wittenberg, A.; Allaire, E.; Becquemin, J. P.; Cochennec, F.; Desgranges, P.; Hosseini, H.; Kobeiter, H.; Marzelle, J.; Bergeron, P.; Padovani, R.; Trastour, J. C.; Biermaier, B.; Gissler, H. M.; Klotzsch, C.; Pfeiffer, T.; Schneider, R.; Soehl, L.; Wennrih, M.; Bausback, Y.; Botsios, S.; Branzan, D.; Braunlich, S.; Holzer, H.; Lenzer, J.; Reichenbecher, C.; Piorkowski, C.; Schuster, J.; Scheinert, D.; Schmidt, A.; Ulrich, M.; Werner, M.; Coster, A.; Engelhardt, A.; Ratusinski, C. M.; Berekoven, B.; Frerker, K.; Gordon, V.; Torsello, G.; Bellenis, I.; Polydorou, A.; Polydorou, V.; Tavernarakis, A.; Ioannou, N.; Terzoudi, M.; Chatzinikou, E.; Giannoukas, A.; Hadjigeorgiou, G.; Koutsias, S.; Ralli, S.; Rousas, N.; Nemes, B.; Jàrànyi, Z.; Szabo, A.; Varga, D.; Barzo, P.; Bodosi, M.; Fako, E.; Fulop, B.; Kuncz, A.; Nagy, E.; Nemeth, T.; Pazdernyik, S.; Skoba, K.; Voros, E.; Haider, S. N.; Harbison, J.; Madhavan, P.; Moore, D.; Beyar, R.; Hoffman, A.; Karram, T.; Kerner, A.; Nikolsky, E.; Nitecki, S.; Amatucci, G.; Vittorio, P.; Frederico, [No Value]; Marinazzo, D.; Regina, G.; Giaquinta, A.; Patti, F.; Veroux, M.; Veroux, P.; Adobbati, L.; Bertoni, G.; Bianchi, P.; Casana, R.; Cireni, L.; Martello, L.; Tolva, V.; Arcuri, L.; Casoni, F.; Coppi, G.; Moratto, R.; Veronesi, J.; Bajardi, G.; Savettieri, G.; Corbetta, R.; Odero, A.; Quaretti, P.; Thyrion, Z.; Cao, P.; Caso, V.; DeRango, P.; Farchioni, L.; Parlani, G.; Malferrari, G.; Strozzi, F.; Tusini, N.; Vecchiati, E.; Biello, A.; Capoccia, L.; Menna, D.; Rita Rizzo, A.; Sbarigia, E.; Speziale, F.; Toni, D.; Giovanni, M.; Meola, G.; Nano, G.; Occiuto, M. T.; Stegher, S.; Tealdi, D.; Accrocca, F.; Ambrogi, C.; Barbazza, R.; Marcucci, G.; Cappelli, A.; De Donato, G.; Palasciano, G.; Pieragalli, D.; Setacci, C.; Settaci, F.; Labate, C.; Ferrero, E.; Ferri, M.; Nessi, F.; Viazzo, A.; Castelli, P.; Delodovici, M. L.; Ferrario, M.; Piffaretti, G.; Tomei, G.; Furui, E.; Inoue, T.; Kondo, R.; Matsumoto, Y.; Shimizu, H.; Aidashova, B.; Kospanov, N.; Lyssenko, R.; Mussagaliev, D.; De Borst, G. J.; Den Hartog, A. G.; Lo, R.; Moll, F.; Toorop, R.; Van Der Worp, H. B.; Vonken, E. J.; Bakke, S.; Krohg-Sorensen, K.; Skjelland, M.; Andziak, P.; Drelichowski, S.; Dratwicki, M.; Gil, R.; Iwanowski, W.; Koncewicz, K.; Nowicki, M.; Pniewski, J.; Rzezak, J.; Seweryniak, P.; Bialek, P.; Biejat, Z.; Czepel, W.; Czlonkowska, A.; Dowzenko, A.; Jedzrejewska, J.; Kobayashi, A.; Leszezyuski, J.; Malek, A.; Polanski, J.; Proczka, R.; Skorski, M.; Szostek, M.; Aleksic, N.; Babic, S.; Kolar, J.; Radak, D.; Sagic, D.; Tanaskovic, S.; Colic, M.; Davidovic, L.; Jovanovic, D.; Koncar, I.; Bartko, D.; Beno, P.; Rusnak, F.; Zelenak, K.; Gasparini, M.; Grad, A.; Kompara, I.; Milosevic, Z.; Flis, V.; Matela, J.; Miksic, K.; Milotic, F.; Mrdja, B.; Stirn, B.; Tetickovic, E.; Chamorro, A.; Obach, V.; Riambau, V.; Roman, S.; Blanco, E.; Izquierdo, A. Y.; Guerra, M.; Campbell, E.; Lindgren, H.; Nyberg, J.; Plate, G.; Parsson, H.; Qvarfordt, P.; Acosta, S.; Bjorses, K.; Brandt, K.; Dias, N.; Gottsater, A.; Holst, J.; Kristmundsson, T.; Kuhme, T.; Kolbel, T.; Lindblad, B.; Lindh, M.; Malina, M.; Ohrlander, T.; Resch, T.; Rönnle, V.; Sonesson, B.; Warvsten, M.; Zdanowski, Z.; Bengt, B.; Delle, M.; Formgren, J.; Gillgren, P.; Jarl, L.; Kall, T. B.; Konrad, P.; Nyman, N.; Skioldebrand, C.; Steuer, J.; Takolander, R.; Ahlhelm, F. J.; Bonati, L.; Engelter, S. S.; Eugster, T.; Gensicke, H.; Lyrer, P.; Mariani, L.; Stierli, P.; Stippich, C.; Wolff, T.; Mehrzad, A.; Brown, E.; Esisi, B.; Butler, N.; Day, D. J.; Hayes, P.; Higgins, N.; Jumilla, E.; Martin, P.; Mitchell, J.; Varty, K.; Birt, A.; Davies, P.; George, J.; Graham, A.; Jonker, L.; Joseph, T.; Kelsall, N.; Potts, C.; Wilson, T.; Davey, P.; Hayman, R.; Tervitt, G.; Abdul-Hamiq, A.; Bryce, J.; Chetter, I.; Ettles, D.; Lakshminarayan, R.; Mitchelsonm, K.; Rhymes, C.; Robinson, G.; Scott, P.; Vickers, A.; Baht, H.; Balogun, I.; Burger, I.; Cowie, L.; Gunathilagan, G.; Hargroves, D.; Insall, R.; Jones, S.; Rudenko, H.; Senaratne, J.; Thomas, G.; Thomson, A.; Enevoldson, P.; Nahser, H.; O'Brian, I.; Torella, F.; Watling, D.; White, R.; Clifton, A.; Eley, C.; Khanom, N.; O'Reilly, J.; Pereira, A.; Bicknell, C.; Cheshire, N.; Gibbs, R.; Hamady, M.; James, A.; Jenkins, M.; Lacey, A.; Mireskandari, M.; Sachs, T.; Wolfe, J.; Hardy, D.; Justin, F.; Phiri, L.; Sekaran, L.; Sethuraman, S.; Tate, L.; Akyea-Mensah, J.; Chrisopoulou, A.; Smyth, J. V.; Nichol, I.; Parry, A.; Young, G.; Clarke, M.; Davis, M.; Dixit, A.; Dyker, A.; Ford, G.; Jackson, R.; Kappadath, S.; Lambert, D.; Lees, T.; Louw, S.; Macdonald, S.; Parr, N.; Stansby, G.; Wales, L.; Wealleans, V.; Wilson, L.; Wyatt, M.; Dorman, P.; Hughes, A.; Jones, D.; Mendelow, A. D.; Rodgers, H.; MacSweeney, S.; McConachie, N.; Southam, A.; Sunman, W.; Briley, D.; Darby, C.; Handa, A.; Hands, L.; Kuker, W.; Michael, K.; Perkins, J.; Schulz, U.; Smith, D.; Teal, R.; Donnelly, M.; D'Souza, S.; Asehosem Egun, A.; Gregory, B.; Kelly, C.; Punekar, S.; Raj, S.; Seriki, D.; Thomson, G.; Beard, J.; Cleveland, T.; Humphreys, J.; Jenkins, A.; King, C.; Lonsdale, R.; Nair, R.; Nawaz, S.; Okhuoya, F.; Turner, D.; Venables, G.; Brown, J.; Durairajan, R.; Guyler, P.; Harman, P.; Jakeways, M.; Khuoge, C.; Kundu, A.; Loganathan, T.; Sinha, D.; Thompson, V.; Tysoe, S.; Barer, [No Value]; Brown, A.; Crawford, S.; Dunlop, P.; Majmudar, [No Value]; Mitchell, D.; O'Brien, [No Value]; O'Connell, [No Value]; Scott, [No Value]; Vetrivel, S.; Ashleigh, R.; Butterfield, S.; Gamble, G.; Ghosh, J.; McCollum, C.; Welch, M.; Welsh, S.; Kazan, V.; Nazzal, M.; Ramsey-Williams, V.

In: European Journal of Vascular and Endovascular Surgery, Vol. 46, No. 5, 11.2013, p. 510-518.

Research output: Contribution to journalArticle

Cras, P, Hendriks, JMH, Lauwers, P, Hertoghs, M, Van Schil, P, De Jaegher, L, Peeters, P, Verbist, J, Dendooven, D, De Letter, J, Vanhooren, G, Astarci, P, Capron, I, Choghari, C, Hammer, F, Lacroix, V, Peeters, A, Verhelst, R, Bosiers, M, De Meester, K, Deloose, K, Van Buggenhout, E, Vinck, E, Geenens, M, Hemelsoet, D, Van Herzeele, I, Vermassen, F, De Koster, G, Desiron, Q, Maertens De Noordhout, A, Malmendier, D, Massoz, M, Saad, G, Cirelli, S, Dormal, P, Lerut, P, Thues, E, Coutts, S, Demchuk, A, Hill, M, Hudon, M, Klein, G, McClelland, M, Morrish, W, Samis, G, Sutherland, G, Watson, T, Wong, J, Liu, B, Liu, CW, Barankova, L, Chlouba, V, Fiedler, J, Priban, V, Sterba, L, Kalabova, L, Kriz, Z, Krupa, P, Privara, M, Reif, M, Souckova, L, Staffa, R, Vlachovsky, R, Vojtisek, B, Hrbac, T, Kuliha, M, Prochazka, V, Roubec, M, Skoloudik, D, Abd Allah, F, Eldessoki, MH, Heshmat Kassem, H, Soliman Gharieb, H, Cardon, JM, Le Gallou Wittenberg, A, Allaire, E, Becquemin, JP, Cochennec, F, Desgranges, P, Hosseini, H, Kobeiter, H, Marzelle, J, Bergeron, P, Padovani, R, Trastour, JC, Biermaier, B, Gissler, HM, Klotzsch, C, Pfeiffer, T, Schneider, R, Soehl, L, Wennrih, M, Bausback, Y, Botsios, S, Branzan, D, Braunlich, S, Holzer, H, Lenzer, J, Reichenbecher, C, Piorkowski, C, Schuster, J, Scheinert, D, Schmidt, A, Ulrich, M, Werner, M, Coster, A, Engelhardt, A, Ratusinski, CM, Berekoven, B, Frerker, K, Gordon, V, Torsello, G, Bellenis, I, Polydorou, A, Polydorou, V, Tavernarakis, A, Ioannou, N, Terzoudi, M, Chatzinikou, E, Giannoukas, A, Hadjigeorgiou, G, Koutsias, S, Ralli, S, Rousas, N, Nemes, B, Jàrànyi, Z, Szabo, A, Varga, D, Barzo, P, Bodosi, M, Fako, E, Fulop, B, Kuncz, A, Nagy, E, Nemeth, T, Pazdernyik, S, Skoba, K, Voros, E, Haider, SN, Harbison, J, Madhavan, P, Moore, D, Beyar, R, Hoffman, A, Karram, T, Kerner, A, Nikolsky, E, Nitecki, S, Amatucci, G, Vittorio, P, Frederico, NV, Marinazzo, D, Regina, G, Giaquinta, A, Patti, F, Veroux, M, Veroux, P, Adobbati, L, Bertoni, G, Bianchi, P, Casana, R, Cireni, L, Martello, L, Tolva, V, Arcuri, L, Casoni, F, Coppi, G, Moratto, R, Veronesi, J, Bajardi, G, Savettieri, G, Corbetta, R, Odero, A, Quaretti, P, Thyrion, Z, Cao, P, Caso, V, DeRango, P, Farchioni, L, Parlani, G, Malferrari, G, Strozzi, F, Tusini, N, Vecchiati, E, Biello, A, Capoccia, L, Menna, D, Rita Rizzo, A, Sbarigia, E, Speziale, F, Toni, D, Giovanni, M, Meola, G, Nano, G, Occiuto, MT, Stegher, S, Tealdi, D, Accrocca, F, Ambrogi, C, Barbazza, R, Marcucci, G, Cappelli, A, De Donato, G, Palasciano, G, Pieragalli, D, Setacci, C, Settaci, F, Labate, C, Ferrero, E, Ferri, M, Nessi, F, Viazzo, A, Castelli, P, Delodovici, ML, Ferrario, M, Piffaretti, G, Tomei, G, Furui, E, Inoue, T, Kondo, R, Matsumoto, Y, Shimizu, H, Aidashova, B, Kospanov, N, Lyssenko, R, Mussagaliev, D, De Borst, GJ, Den Hartog, AG, Lo, R, Moll, F, Toorop, R, Van Der Worp, HB, Vonken, EJ, Bakke, S, Krohg-Sorensen, K, Skjelland, M, Andziak, P, Drelichowski, S, Dratwicki, M, Gil, R, Iwanowski, W, Koncewicz, K, Nowicki, M, Pniewski, J, Rzezak, J, Seweryniak, P, Bialek, P, Biejat, Z, Czepel, W, Czlonkowska, A, Dowzenko, A, Jedzrejewska, J, Kobayashi, A, Leszezyuski, J, Malek, A, Polanski, J, Proczka, R, Skorski, M, Szostek, M, Aleksic, N, Babic, S, Kolar, J, Radak, D, Sagic, D, Tanaskovic, S, Colic, M, Davidovic, L, Jovanovic, D, Koncar, I, Bartko, D, Beno, P, Rusnak, F, Zelenak, K, Gasparini, M, Grad, A, Kompara, I, Milosevic, Z, Flis, V, Matela, J, Miksic, K, Milotic, F, Mrdja, B, Stirn, B, Tetickovic, E, Chamorro, A, Obach, V, Riambau, V, Roman, S, Blanco, E, Izquierdo, AY, Guerra, M, Campbell, E, Lindgren, H, Nyberg, J, Plate, G, Parsson, H, Qvarfordt, P, Acosta, S, Bjorses, K, Brandt, K, Dias, N, Gottsater, A, Holst, J, Kristmundsson, T, Kuhme, T, Kolbel, T, Lindblad, B, Lindh, M, Malina, M, Ohrlander, T, Resch, T, Rönnle, V, Sonesson, B, Warvsten, M, Zdanowski, Z, Bengt, B, Delle, M, Formgren, J, Gillgren, P, Jarl, L, Kall, TB, Konrad, P, Nyman, N, Skioldebrand, C, Steuer, J, Takolander, R, Ahlhelm, FJ, Bonati, L, Engelter, SS, Eugster, T, Gensicke, H, Lyrer, P, Mariani, L, Stierli, P, Stippich, C, Wolff, T, Mehrzad, A, Brown, E, Esisi, B, Butler, N, Day, DJ, Hayes, P, Higgins, N, Jumilla, E, Martin, P, Mitchell, J, Varty, K, Birt, A, Davies, P, George, J, Graham, A, Jonker, L, Joseph, T, Kelsall, N, Potts, C, Wilson, T, Davey, P, Hayman, R, Tervitt, G, Abdul-Hamiq, A, Bryce, J, Chetter, I, Ettles, D, Lakshminarayan, R, Mitchelsonm, K, Rhymes, C, Robinson, G, Scott, P, Vickers, A, Baht, H, Balogun, I, Burger, I, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, Jones, S, Rudenko, H, Senaratne, J, Thomas, G, Thomson, A, Enevoldson, P, Nahser, H, O'Brian, I, Torella, F, Watling, D, White, R, Clifton, A, Eley, C, Khanom, N, O'Reilly, J, Pereira, A, Bicknell, C, Cheshire, N, Gibbs, R, Hamady, M, James, A, Jenkins, M, Lacey, A, Mireskandari, M, Sachs, T, Wolfe, J, Hardy, D, Justin, F, Phiri, L, Sekaran, L, Sethuraman, S, Tate, L, Akyea-Mensah, J, Chrisopoulou, A, Smyth, JV, Nichol, I, Parry, A, Young, G, Clarke, M, Davis, M, Dixit, A, Dyker, A, Ford, G, Jackson, R, Kappadath, S, Lambert, D, Lees, T, Louw, S, Macdonald, S, Parr, N, Stansby, G, Wales, L, Wealleans, V, Wilson, L, Wyatt, M, Dorman, P, Hughes, A, Jones, D, Mendelow, AD, Rodgers, H, MacSweeney, S, McConachie, N, Southam, A, Sunman, W, Briley, D, Darby, C, Handa, A, Hands, L, Kuker, W, Michael, K, Perkins, J, Schulz, U, Smith, D, Teal, R, Donnelly, M, D'Souza, S, Asehosem Egun, A, Gregory, B, Kelly, C, Punekar, S, Raj, S, Seriki, D, Thomson, G, Beard, J, Cleveland, T, Humphreys, J, Jenkins, A, King, C, Lonsdale, R, Nair, R, Nawaz, S, Okhuoya, F, Turner, D, Venables, G, Brown, J, Durairajan, R, Guyler, P, Harman, P, Jakeways, M, Khuoge, C, Kundu, A, Loganathan, T, Sinha, D, Thompson, V, Tysoe, S, Barer, NV, Brown, A, Crawford, S, Dunlop, P, Majmudar, NV, Mitchell, D, O'Brien, NV, O'Connell, NV, Scott, NV, Vetrivel, S, Ashleigh, R, Butterfield, S, Gamble, G, Ghosh, J, McCollum, C, Welch, M, Welsh, S, Kazan, V, Nazzal, M & Ramsey-Williams, V 2013, 'Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)', European Journal of Vascular and Endovascular Surgery, vol. 46, no. 5, pp. 510-518. https://doi.org/10.1016/j.ejvs.2013.07.020
Cras, P. ; Hendriks, J. M H ; Lauwers, P. ; Hertoghs, M. ; Van Schil, P. ; De Jaegher, L. ; Peeters, P. ; Verbist, J. ; Dendooven, D. ; De Letter, J. ; Vanhooren, G. ; Astarci, P. ; Capron, I. ; Choghari, C. ; Hammer, F. ; Lacroix, V. ; Peeters, A. ; Verhelst, R. ; Bosiers, M. ; De Meester, K. ; Deloose, K. ; Van Buggenhout, E. ; Vinck, E. ; Geenens, M. ; Hemelsoet, D. ; Van Herzeele, I. ; Vermassen, F. ; De Koster, G. ; Desiron, Q. ; Maertens De Noordhout, A. ; Malmendier, D. ; Massoz, M. ; Saad, G. ; Cirelli, S. ; Dormal, P. ; Lerut, P. ; Thues, E. ; Coutts, S. ; Demchuk, A. ; Hill, M. ; Hudon, M. ; Klein, G. ; McClelland, M. ; Morrish, W. ; Samis, G. ; Sutherland, G. ; Watson, T. ; Wong, J. ; Liu, Bao ; Liu, Chang Wei ; Barankova, L. ; Chlouba, V. ; Fiedler, J. ; Priban, V. ; Sterba, L. ; Kalabova, L. ; Kriz, Z. ; Krupa, P. ; Privara, M. ; Reif, M. ; Souckova, L. ; Staffa, R. ; Vlachovsky, R. ; Vojtisek, B. ; Hrbac, T. ; Kuliha, M. ; Prochazka, V. ; Roubec, M. ; Skoloudik, D. ; Abd Allah, F. ; Eldessoki, M. H. ; Heshmat Kassem, H. ; Soliman Gharieb, H. ; Cardon, J. M. ; Le Gallou Wittenberg, A. ; Allaire, E. ; Becquemin, J. P. ; Cochennec, F. ; Desgranges, P. ; Hosseini, H. ; Kobeiter, H. ; Marzelle, J. ; Bergeron, P. ; Padovani, R. ; Trastour, J. C. ; Biermaier, B. ; Gissler, H. M. ; Klotzsch, C. ; Pfeiffer, T. ; Schneider, R. ; Soehl, L. ; Wennrih, M. ; Bausback, Y. ; Botsios, S. ; Branzan, D. ; Braunlich, S. ; Holzer, H. ; Lenzer, J. ; Reichenbecher, C. ; Piorkowski, C. ; Schuster, J. ; Scheinert, D. ; Schmidt, A. ; Ulrich, M. ; Werner, M. ; Coster, A. ; Engelhardt, A. ; Ratusinski, C. M. ; Berekoven, B. ; Frerker, K. ; Gordon, V. ; Torsello, G. ; Bellenis, I. ; Polydorou, A. ; Polydorou, V. ; Tavernarakis, A. ; Ioannou, N. ; Terzoudi, M. ; Chatzinikou, E. ; Giannoukas, A. ; Hadjigeorgiou, G. ; Koutsias, S. ; Ralli, S. ; Rousas, N. ; Nemes, B. ; Jàrànyi, Z. ; Szabo, A. ; Varga, D. ; Barzo, P. ; Bodosi, M. ; Fako, E. ; Fulop, B. ; Kuncz, A. ; Nagy, E. ; Nemeth, T. ; Pazdernyik, S. ; Skoba, K. ; Voros, E. ; Haider, S. N. ; Harbison, J. ; Madhavan, P. ; Moore, D. ; Beyar, R. ; Hoffman, A. ; Karram, T. ; Kerner, A. ; Nikolsky, E. ; Nitecki, S. ; Amatucci, G. ; Vittorio, P. ; Frederico, [No Value] ; Marinazzo, D. ; Regina, G. ; Giaquinta, A. ; Patti, F. ; Veroux, M. ; Veroux, P. ; Adobbati, L. ; Bertoni, G. ; Bianchi, P. ; Casana, R. ; Cireni, L. ; Martello, L. ; Tolva, V. ; Arcuri, L. ; Casoni, F. ; Coppi, G. ; Moratto, R. ; Veronesi, J. ; Bajardi, G. ; Savettieri, G. ; Corbetta, R. ; Odero, A. ; Quaretti, P. ; Thyrion, Z. ; Cao, P. ; Caso, V. ; DeRango, P. ; Farchioni, L. ; Parlani, G. ; Malferrari, G. ; Strozzi, F. ; Tusini, N. ; Vecchiati, E. ; Biello, A. ; Capoccia, L. ; Menna, D. ; Rita Rizzo, A. ; Sbarigia, E. ; Speziale, F. ; Toni, D. ; Giovanni, M. ; Meola, G. ; Nano, G. ; Occiuto, M. T. ; Stegher, S. ; Tealdi, D. ; Accrocca, F. ; Ambrogi, C. ; Barbazza, R. ; Marcucci, G. ; Cappelli, A. ; De Donato, G. ; Palasciano, G. ; Pieragalli, D. ; Setacci, C. ; Settaci, F. ; Labate, C. ; Ferrero, E. ; Ferri, M. ; Nessi, F. ; Viazzo, A. ; Castelli, P. ; Delodovici, M. L. ; Ferrario, M. ; Piffaretti, G. ; Tomei, G. ; Furui, E. ; Inoue, T. ; Kondo, R. ; Matsumoto, Y. ; Shimizu, H. ; Aidashova, B. ; Kospanov, N. ; Lyssenko, R. ; Mussagaliev, D. ; De Borst, G. J. ; Den Hartog, A. G. ; Lo, R. ; Moll, F. ; Toorop, R. ; Van Der Worp, H. B. ; Vonken, E. J. ; Bakke, S. ; Krohg-Sorensen, K. ; Skjelland, M. ; Andziak, P. ; Drelichowski, S. ; Dratwicki, M. ; Gil, R. ; Iwanowski, W. ; Koncewicz, K. ; Nowicki, M. ; Pniewski, J. ; Rzezak, J. ; Seweryniak, P. ; Bialek, P. ; Biejat, Z. ; Czepel, W. ; Czlonkowska, A. ; Dowzenko, A. ; Jedzrejewska, J. ; Kobayashi, A. ; Leszezyuski, J. ; Malek, A. ; Polanski, J. ; Proczka, R. ; Skorski, M. ; Szostek, M. ; Aleksic, N. ; Babic, S. ; Kolar, J. ; Radak, D. ; Sagic, D. ; Tanaskovic, S. ; Colic, M. ; Davidovic, L. ; Jovanovic, D. ; Koncar, I. ; Bartko, D. ; Beno, P. ; Rusnak, F. ; Zelenak, K. ; Gasparini, M. ; Grad, A. ; Kompara, I. ; Milosevic, Z. ; Flis, V. ; Matela, J. ; Miksic, K. ; Milotic, F. ; Mrdja, B. ; Stirn, B. ; Tetickovic, E. ; Chamorro, A. ; Obach, V. ; Riambau, V. ; Roman, S. ; Blanco, E. ; Izquierdo, A. Y. ; Guerra, M. ; Campbell, E. ; Lindgren, H. ; Nyberg, J. ; Plate, G. ; Parsson, H. ; Qvarfordt, P. ; Acosta, S. ; Bjorses, K. ; Brandt, K. ; Dias, N. ; Gottsater, A. ; Holst, J. ; Kristmundsson, T. ; Kuhme, T. ; Kolbel, T. ; Lindblad, B. ; Lindh, M. ; Malina, M. ; Ohrlander, T. ; Resch, T. ; Rönnle, V. ; Sonesson, B. ; Warvsten, M. ; Zdanowski, Z. ; Bengt, B. ; Delle, M. ; Formgren, J. ; Gillgren, P. ; Jarl, L. ; Kall, T. B. ; Konrad, P. ; Nyman, N. ; Skioldebrand, C. ; Steuer, J. ; Takolander, R. ; Ahlhelm, F. J. ; Bonati, L. ; Engelter, S. S. ; Eugster, T. ; Gensicke, H. ; Lyrer, P. ; Mariani, L. ; Stierli, P. ; Stippich, C. ; Wolff, T. ; Mehrzad, A. ; Brown, E. ; Esisi, B. ; Butler, N. ; Day, D. J. ; Hayes, P. ; Higgins, N. ; Jumilla, E. ; Martin, P. ; Mitchell, J. ; Varty, K. ; Birt, A. ; Davies, P. ; George, J. ; Graham, A. ; Jonker, L. ; Joseph, T. ; Kelsall, N. ; Potts, C. ; Wilson, T. ; Davey, P. ; Hayman, R. ; Tervitt, G. ; Abdul-Hamiq, A. ; Bryce, J. ; Chetter, I. ; Ettles, D. ; Lakshminarayan, R. ; Mitchelsonm, K. ; Rhymes, C. ; Robinson, G. ; Scott, P. ; Vickers, A. ; Baht, H. ; Balogun, I. ; Burger, I. ; Cowie, L. ; Gunathilagan, G. ; Hargroves, D. ; Insall, R. ; Jones, S. ; Rudenko, H. ; Senaratne, J. ; Thomas, G. ; Thomson, A. ; Enevoldson, P. ; Nahser, H. ; O'Brian, I. ; Torella, F. ; Watling, D. ; White, R. ; Clifton, A. ; Eley, C. ; Khanom, N. ; O'Reilly, J. ; Pereira, A. ; Bicknell, C. ; Cheshire, N. ; Gibbs, R. ; Hamady, M. ; James, A. ; Jenkins, M. ; Lacey, A. ; Mireskandari, M. ; Sachs, T. ; Wolfe, J. ; Hardy, D. ; Justin, F. ; Phiri, L. ; Sekaran, L. ; Sethuraman, S. ; Tate, L. ; Akyea-Mensah, J. ; Chrisopoulou, A. ; Smyth, J. V. ; Nichol, I. ; Parry, A. ; Young, G. ; Clarke, M. ; Davis, M. ; Dixit, A. ; Dyker, A. ; Ford, G. ; Jackson, R. ; Kappadath, S. ; Lambert, D. ; Lees, T. ; Louw, S. ; Macdonald, S. ; Parr, N. ; Stansby, G. ; Wales, L. ; Wealleans, V. ; Wilson, L. ; Wyatt, M. ; Dorman, P. ; Hughes, A. ; Jones, D. ; Mendelow, A. D. ; Rodgers, H. ; MacSweeney, S. ; McConachie, N. ; Southam, A. ; Sunman, W. ; Briley, D. ; Darby, C. ; Handa, A. ; Hands, L. ; Kuker, W. ; Michael, K. ; Perkins, J. ; Schulz, U. ; Smith, D. ; Teal, R. ; Donnelly, M. ; D'Souza, S. ; Asehosem Egun, A. ; Gregory, B. ; Kelly, C. ; Punekar, S. ; Raj, S. ; Seriki, D. ; Thomson, G. ; Beard, J. ; Cleveland, T. ; Humphreys, J. ; Jenkins, A. ; King, C. ; Lonsdale, R. ; Nair, R. ; Nawaz, S. ; Okhuoya, F. ; Turner, D. ; Venables, G. ; Brown, J. ; Durairajan, R. ; Guyler, P. ; Harman, P. ; Jakeways, M. ; Khuoge, C. ; Kundu, A. ; Loganathan, T. ; Sinha, D. ; Thompson, V. ; Tysoe, S. ; Barer, [No Value] ; Brown, A. ; Crawford, S. ; Dunlop, P. ; Majmudar, [No Value] ; Mitchell, D. ; O'Brien, [No Value] ; O'Connell, [No Value] ; Scott, [No Value] ; Vetrivel, S. ; Ashleigh, R. ; Butterfield, S. ; Gamble, G. ; Ghosh, J. ; McCollum, C. ; Welch, M. ; Welsh, S. ; Kazan, V. ; Nazzal, M. ; Ramsey-Williams, V. / Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2). In: European Journal of Vascular and Endovascular Surgery. 2013 ; Vol. 46, No. 5. pp. 510-518.
@article{892ffd82d82a4177af393faf2baa6883,
title = "Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)",
abstract = "Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96{\%}) had ipsilateral stenosis of 70-99{\%} (median 80{\%}) with contralateral stenoses of 50-99{\%} in 30{\%} and contralateral occlusion in 8{\%}. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0{\%}. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362.",
keywords = "Carotid artery stenosis, Carotid artery stenting, Carotid endarterectomy, Randomized controlled trial, Stroke",
author = "P. Cras and Hendriks, {J. M H} and P. Lauwers and M. Hertoghs and {Van Schil}, P. and {De Jaegher}, L. and P. Peeters and J. Verbist and D. Dendooven and {De Letter}, J. and G. Vanhooren and P. Astarci and I. Capron and C. Choghari and F. Hammer and V. Lacroix and A. Peeters and R. Verhelst and M. Bosiers and {De Meester}, K. and K. Deloose and {Van Buggenhout}, E. and E. Vinck and M. Geenens and D. Hemelsoet and {Van Herzeele}, I. and F. Vermassen and {De Koster}, G. and Q. Desiron and {Maertens De Noordhout}, A. and D. Malmendier and M. Massoz and G. Saad and S. Cirelli and P. Dormal and P. Lerut and E. Thues and S. Coutts and A. Demchuk and M. Hill and M. Hudon and G. Klein and M. McClelland and W. Morrish and G. Samis and G. Sutherland and T. Watson and J. Wong and Bao Liu and Liu, {Chang Wei} and L. Barankova and V. Chlouba and J. Fiedler and V. Priban and L. Sterba and L. Kalabova and Z. Kriz and P. Krupa and M. Privara and M. Reif and L. Souckova and R. Staffa and R. Vlachovsky and B. Vojtisek and T. Hrbac and M. Kuliha and V. Prochazka and M. Roubec and D. Skoloudik and {Abd Allah}, F. and Eldessoki, {M. H.} and {Heshmat Kassem}, H. and {Soliman Gharieb}, H. and Cardon, {J. M.} and {Le Gallou Wittenberg}, A. and E. Allaire and Becquemin, {J. P.} and F. Cochennec and P. Desgranges and H. Hosseini and H. Kobeiter and J. Marzelle and P. Bergeron and R. Padovani and Trastour, {J. C.} and B. Biermaier and Gissler, {H. M.} and C. Klotzsch and T. Pfeiffer and R. Schneider and L. Soehl and M. Wennrih and Y. Bausback and S. Botsios and D. Branzan and S. Braunlich and H. Holzer and J. Lenzer and C. Reichenbecher and C. Piorkowski and J. Schuster and D. Scheinert and A. Schmidt and M. Ulrich and M. Werner and A. Coster and A. Engelhardt and Ratusinski, {C. M.} and B. Berekoven and K. Frerker and V. Gordon and G. Torsello and I. Bellenis and A. Polydorou and V. Polydorou and A. Tavernarakis and N. Ioannou and M. Terzoudi and E. Chatzinikou and A. Giannoukas and G. Hadjigeorgiou and S. Koutsias and S. Ralli and N. Rousas and B. Nemes and Z. J{\`a}r{\`a}nyi and A. Szabo and D. Varga and P. Barzo and M. Bodosi and E. Fako and B. Fulop and A. Kuncz and E. Nagy and T. Nemeth and S. Pazdernyik and K. Skoba and E. Voros and Haider, {S. N.} and J. Harbison and P. Madhavan and D. Moore and R. Beyar and A. Hoffman and T. Karram and A. Kerner and E. Nikolsky and S. Nitecki and G. Amatucci and P. Vittorio and Frederico, {[No Value]} and D. Marinazzo and G. Regina and A. Giaquinta and F. Patti and M. Veroux and P. Veroux and L. Adobbati and G. Bertoni and P. Bianchi and R. Casana and L. Cireni and L. Martello and V. Tolva and L. Arcuri and F. Casoni and G. Coppi and R. Moratto and J. Veronesi and G. Bajardi and G. Savettieri and R. Corbetta and A. Odero and P. Quaretti and Z. Thyrion and P. Cao and V. Caso and P. DeRango and L. Farchioni and G. Parlani and G. Malferrari and F. Strozzi and N. Tusini and E. Vecchiati and A. Biello and L. Capoccia and D. Menna and {Rita Rizzo}, A. and E. Sbarigia and F. Speziale and D. Toni and M. Giovanni and G. Meola and G. Nano and Occiuto, {M. T.} and S. Stegher and D. Tealdi and F. Accrocca and C. Ambrogi and R. Barbazza and G. Marcucci and A. Cappelli and {De Donato}, G. and G. Palasciano and D. Pieragalli and C. Setacci and F. Settaci and C. Labate and E. Ferrero and M. Ferri and F. Nessi and A. Viazzo and P. Castelli and Delodovici, {M. L.} and M. Ferrario and G. Piffaretti and G. Tomei and E. Furui and T. Inoue and R. Kondo and Y. Matsumoto and H. Shimizu and B. Aidashova and N. Kospanov and R. Lyssenko and D. Mussagaliev and {De Borst}, {G. J.} and {Den Hartog}, {A. G.} and R. Lo and F. Moll and R. Toorop and {Van Der Worp}, {H. B.} and Vonken, {E. J.} and S. Bakke and K. Krohg-Sorensen and M. Skjelland and P. Andziak and S. Drelichowski and M. Dratwicki and R. Gil and W. Iwanowski and K. Koncewicz and M. Nowicki and J. Pniewski and J. Rzezak and P. Seweryniak and P. Bialek and Z. Biejat and W. Czepel and A. Czlonkowska and A. Dowzenko and J. Jedzrejewska and A. Kobayashi and J. Leszezyuski and A. Malek and J. Polanski and R. Proczka and M. Skorski and M. Szostek and N. Aleksic and S. Babic and J. Kolar and D. Radak and D. Sagic and S. Tanaskovic and M. Colic and L. Davidovic and D. Jovanovic and I. Koncar and D. Bartko and P. Beno and F. Rusnak and K. Zelenak and M. Gasparini and A. Grad and I. Kompara and Z. Milosevic and V. Flis and J. Matela and K. Miksic and F. Milotic and B. Mrdja and B. Stirn and E. Tetickovic and A. Chamorro and V. Obach and V. Riambau and S. Roman and E. Blanco and Izquierdo, {A. Y.} and M. Guerra and E. Campbell and H. Lindgren and J. Nyberg and G. Plate and H. Parsson and P. Qvarfordt and S. Acosta and K. Bjorses and K. Brandt and N. Dias and A. Gottsater and J. Holst and T. Kristmundsson and T. Kuhme and T. Kolbel and B. Lindblad and M. Lindh and M. Malina and T. Ohrlander and T. Resch and V. R{\"o}nnle and B. Sonesson and M. Warvsten and Z. Zdanowski and B. Bengt and M. Delle and J. Formgren and P. Gillgren and L. Jarl and Kall, {T. B.} and P. Konrad and N. Nyman and C. Skioldebrand and J. Steuer and R. Takolander and Ahlhelm, {F. J.} and L. Bonati and Engelter, {S. S.} and T. Eugster and H. Gensicke and P. Lyrer and L. Mariani and P. Stierli and C. Stippich and T. Wolff and A. Mehrzad and E. Brown and B. Esisi and N. Butler and Day, {D. J.} and P. Hayes and N. Higgins and E. Jumilla and P. Martin and J. Mitchell and K. Varty and A. Birt and P. Davies and J. George and A. Graham and L. Jonker and T. Joseph and N. Kelsall and C. Potts and T. Wilson and P. Davey and R. Hayman and G. Tervitt and A. Abdul-Hamiq and J. Bryce and I. Chetter and D. Ettles and R. Lakshminarayan and K. Mitchelsonm and C. Rhymes and G. Robinson and P. Scott and A. Vickers and H. Baht and I. Balogun and I. Burger and L. Cowie and G. Gunathilagan and D. Hargroves and R. Insall and S. Jones and H. Rudenko and J. Senaratne and G. Thomas and A. Thomson and P. Enevoldson and H. Nahser and I. O'Brian and F. Torella and D. Watling and R. White and A. Clifton and C. Eley and N. Khanom and J. O'Reilly and A. Pereira and C. Bicknell and N. Cheshire and R. Gibbs and M. Hamady and A. James and M. Jenkins and A. Lacey and M. Mireskandari and T. Sachs and J. Wolfe and D. Hardy and F. Justin and L. Phiri and L. Sekaran and S. Sethuraman and L. Tate and J. Akyea-Mensah and A. Chrisopoulou and Smyth, {J. V.} and I. Nichol and A. Parry and G. Young and M. Clarke and M. Davis and A. Dixit and A. Dyker and G. Ford and R. Jackson and S. Kappadath and D. Lambert and T. Lees and S. Louw and S. Macdonald and N. Parr and G. Stansby and L. Wales and V. Wealleans and L. Wilson and M. Wyatt and P. Dorman and A. Hughes and D. Jones and Mendelow, {A. D.} and H. Rodgers and S. MacSweeney and N. McConachie and A. Southam and W. Sunman and D. Briley and C. Darby and A. Handa and L. Hands and W. Kuker and K. Michael and J. Perkins and U. Schulz and D. Smith and R. Teal and M. Donnelly and S. D'Souza and {Asehosem Egun}, A. and B. Gregory and C. Kelly and S. Punekar and S. Raj and D. Seriki and G. Thomson and J. Beard and T. Cleveland and J. Humphreys and A. Jenkins and C. King and R. Lonsdale and R. Nair and S. Nawaz and F. Okhuoya and D. Turner and G. Venables and J. Brown and R. Durairajan and P. Guyler and P. Harman and M. Jakeways and C. Khuoge and A. Kundu and T. Loganathan and D. Sinha and V. Thompson and S. Tysoe and Barer, {[No Value]} and A. Brown and S. Crawford and P. Dunlop and Majmudar, {[No Value]} and D. Mitchell and O'Brien, {[No Value]} and O'Connell, {[No Value]} and Scott, {[No Value]} and S. Vetrivel and R. Ashleigh and S. Butterfield and G. Gamble and J. Ghosh and C. McCollum and M. Welch and S. Welsh and V. Kazan and M. Nazzal and V. Ramsey-Williams",
year = "2013",
month = "11",
doi = "10.1016/j.ejvs.2013.07.020",
language = "English (US)",
volume = "46",
pages = "510--518",
journal = "European Journal of Vascular and Endovascular Surgery",
issn = "1078-5884",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

AU - Cras, P.

AU - Hendriks, J. M H

AU - Lauwers, P.

AU - Hertoghs, M.

AU - Van Schil, P.

AU - De Jaegher, L.

AU - Peeters, P.

AU - Verbist, J.

AU - Dendooven, D.

AU - De Letter, J.

AU - Vanhooren, G.

AU - Astarci, P.

AU - Capron, I.

AU - Choghari, C.

AU - Hammer, F.

AU - Lacroix, V.

AU - Peeters, A.

AU - Verhelst, R.

AU - Bosiers, M.

AU - De Meester, K.

AU - Deloose, K.

AU - Van Buggenhout, E.

AU - Vinck, E.

AU - Geenens, M.

AU - Hemelsoet, D.

AU - Van Herzeele, I.

AU - Vermassen, F.

AU - De Koster, G.

AU - Desiron, Q.

AU - Maertens De Noordhout, A.

AU - Malmendier, D.

AU - Massoz, M.

AU - Saad, G.

AU - Cirelli, S.

AU - Dormal, P.

AU - Lerut, P.

AU - Thues, E.

AU - Coutts, S.

AU - Demchuk, A.

AU - Hill, M.

AU - Hudon, M.

AU - Klein, G.

AU - McClelland, M.

AU - Morrish, W.

AU - Samis, G.

AU - Sutherland, G.

AU - Watson, T.

AU - Wong, J.

AU - Liu, Bao

AU - Liu, Chang Wei

AU - Barankova, L.

AU - Chlouba, V.

AU - Fiedler, J.

AU - Priban, V.

AU - Sterba, L.

AU - Kalabova, L.

AU - Kriz, Z.

AU - Krupa, P.

AU - Privara, M.

AU - Reif, M.

AU - Souckova, L.

AU - Staffa, R.

AU - Vlachovsky, R.

AU - Vojtisek, B.

AU - Hrbac, T.

AU - Kuliha, M.

AU - Prochazka, V.

AU - Roubec, M.

AU - Skoloudik, D.

AU - Abd Allah, F.

AU - Eldessoki, M. H.

AU - Heshmat Kassem, H.

AU - Soliman Gharieb, H.

AU - Cardon, J. M.

AU - Le Gallou Wittenberg, A.

AU - Allaire, E.

AU - Becquemin, J. P.

AU - Cochennec, F.

AU - Desgranges, P.

AU - Hosseini, H.

AU - Kobeiter, H.

AU - Marzelle, J.

AU - Bergeron, P.

AU - Padovani, R.

AU - Trastour, J. C.

AU - Biermaier, B.

AU - Gissler, H. M.

AU - Klotzsch, C.

AU - Pfeiffer, T.

AU - Schneider, R.

AU - Soehl, L.

AU - Wennrih, M.

AU - Bausback, Y.

AU - Botsios, S.

AU - Branzan, D.

AU - Braunlich, S.

AU - Holzer, H.

AU - Lenzer, J.

AU - Reichenbecher, C.

AU - Piorkowski, C.

AU - Schuster, J.

AU - Scheinert, D.

AU - Schmidt, A.

AU - Ulrich, M.

AU - Werner, M.

AU - Coster, A.

AU - Engelhardt, A.

AU - Ratusinski, C. M.

AU - Berekoven, B.

AU - Frerker, K.

AU - Gordon, V.

AU - Torsello, G.

AU - Bellenis, I.

AU - Polydorou, A.

AU - Polydorou, V.

AU - Tavernarakis, A.

AU - Ioannou, N.

AU - Terzoudi, M.

AU - Chatzinikou, E.

AU - Giannoukas, A.

AU - Hadjigeorgiou, G.

AU - Koutsias, S.

AU - Ralli, S.

AU - Rousas, N.

AU - Nemes, B.

AU - Jàrànyi, Z.

AU - Szabo, A.

AU - Varga, D.

AU - Barzo, P.

AU - Bodosi, M.

AU - Fako, E.

AU - Fulop, B.

AU - Kuncz, A.

AU - Nagy, E.

AU - Nemeth, T.

AU - Pazdernyik, S.

AU - Skoba, K.

AU - Voros, E.

AU - Haider, S. N.

AU - Harbison, J.

AU - Madhavan, P.

AU - Moore, D.

AU - Beyar, R.

AU - Hoffman, A.

AU - Karram, T.

AU - Kerner, A.

AU - Nikolsky, E.

AU - Nitecki, S.

AU - Amatucci, G.

AU - Vittorio, P.

AU - Frederico, [No Value]

AU - Marinazzo, D.

AU - Regina, G.

AU - Giaquinta, A.

AU - Patti, F.

AU - Veroux, M.

AU - Veroux, P.

AU - Adobbati, L.

AU - Bertoni, G.

AU - Bianchi, P.

AU - Casana, R.

AU - Cireni, L.

AU - Martello, L.

AU - Tolva, V.

AU - Arcuri, L.

AU - Casoni, F.

AU - Coppi, G.

AU - Moratto, R.

AU - Veronesi, J.

AU - Bajardi, G.

AU - Savettieri, G.

AU - Corbetta, R.

AU - Odero, A.

AU - Quaretti, P.

AU - Thyrion, Z.

AU - Cao, P.

AU - Caso, V.

AU - DeRango, P.

AU - Farchioni, L.

AU - Parlani, G.

AU - Malferrari, G.

AU - Strozzi, F.

AU - Tusini, N.

AU - Vecchiati, E.

AU - Biello, A.

AU - Capoccia, L.

AU - Menna, D.

AU - Rita Rizzo, A.

AU - Sbarigia, E.

AU - Speziale, F.

AU - Toni, D.

AU - Giovanni, M.

AU - Meola, G.

AU - Nano, G.

AU - Occiuto, M. T.

AU - Stegher, S.

AU - Tealdi, D.

AU - Accrocca, F.

AU - Ambrogi, C.

AU - Barbazza, R.

AU - Marcucci, G.

AU - Cappelli, A.

AU - De Donato, G.

AU - Palasciano, G.

AU - Pieragalli, D.

AU - Setacci, C.

AU - Settaci, F.

AU - Labate, C.

AU - Ferrero, E.

AU - Ferri, M.

AU - Nessi, F.

AU - Viazzo, A.

AU - Castelli, P.

AU - Delodovici, M. L.

AU - Ferrario, M.

AU - Piffaretti, G.

AU - Tomei, G.

AU - Furui, E.

AU - Inoue, T.

AU - Kondo, R.

AU - Matsumoto, Y.

AU - Shimizu, H.

AU - Aidashova, B.

AU - Kospanov, N.

AU - Lyssenko, R.

AU - Mussagaliev, D.

AU - De Borst, G. J.

AU - Den Hartog, A. G.

AU - Lo, R.

AU - Moll, F.

AU - Toorop, R.

AU - Van Der Worp, H. B.

AU - Vonken, E. J.

AU - Bakke, S.

AU - Krohg-Sorensen, K.

AU - Skjelland, M.

AU - Andziak, P.

AU - Drelichowski, S.

AU - Dratwicki, M.

AU - Gil, R.

AU - Iwanowski, W.

AU - Koncewicz, K.

AU - Nowicki, M.

AU - Pniewski, J.

AU - Rzezak, J.

AU - Seweryniak, P.

AU - Bialek, P.

AU - Biejat, Z.

AU - Czepel, W.

AU - Czlonkowska, A.

AU - Dowzenko, A.

AU - Jedzrejewska, J.

AU - Kobayashi, A.

AU - Leszezyuski, J.

AU - Malek, A.

AU - Polanski, J.

AU - Proczka, R.

AU - Skorski, M.

AU - Szostek, M.

AU - Aleksic, N.

AU - Babic, S.

AU - Kolar, J.

AU - Radak, D.

AU - Sagic, D.

AU - Tanaskovic, S.

AU - Colic, M.

AU - Davidovic, L.

AU - Jovanovic, D.

AU - Koncar, I.

AU - Bartko, D.

AU - Beno, P.

AU - Rusnak, F.

AU - Zelenak, K.

AU - Gasparini, M.

AU - Grad, A.

AU - Kompara, I.

AU - Milosevic, Z.

AU - Flis, V.

AU - Matela, J.

AU - Miksic, K.

AU - Milotic, F.

AU - Mrdja, B.

AU - Stirn, B.

AU - Tetickovic, E.

AU - Chamorro, A.

AU - Obach, V.

AU - Riambau, V.

AU - Roman, S.

AU - Blanco, E.

AU - Izquierdo, A. Y.

AU - Guerra, M.

AU - Campbell, E.

AU - Lindgren, H.

AU - Nyberg, J.

AU - Plate, G.

AU - Parsson, H.

AU - Qvarfordt, P.

AU - Acosta, S.

AU - Bjorses, K.

AU - Brandt, K.

AU - Dias, N.

AU - Gottsater, A.

AU - Holst, J.

AU - Kristmundsson, T.

AU - Kuhme, T.

AU - Kolbel, T.

AU - Lindblad, B.

AU - Lindh, M.

AU - Malina, M.

AU - Ohrlander, T.

AU - Resch, T.

AU - Rönnle, V.

AU - Sonesson, B.

AU - Warvsten, M.

AU - Zdanowski, Z.

AU - Bengt, B.

AU - Delle, M.

AU - Formgren, J.

AU - Gillgren, P.

AU - Jarl, L.

AU - Kall, T. B.

AU - Konrad, P.

AU - Nyman, N.

AU - Skioldebrand, C.

AU - Steuer, J.

AU - Takolander, R.

AU - Ahlhelm, F. J.

AU - Bonati, L.

AU - Engelter, S. S.

AU - Eugster, T.

AU - Gensicke, H.

AU - Lyrer, P.

AU - Mariani, L.

AU - Stierli, P.

AU - Stippich, C.

AU - Wolff, T.

AU - Mehrzad, A.

AU - Brown, E.

AU - Esisi, B.

AU - Butler, N.

AU - Day, D. J.

AU - Hayes, P.

AU - Higgins, N.

AU - Jumilla, E.

AU - Martin, P.

AU - Mitchell, J.

AU - Varty, K.

AU - Birt, A.

AU - Davies, P.

AU - George, J.

AU - Graham, A.

AU - Jonker, L.

AU - Joseph, T.

AU - Kelsall, N.

AU - Potts, C.

AU - Wilson, T.

AU - Davey, P.

AU - Hayman, R.

AU - Tervitt, G.

AU - Abdul-Hamiq, A.

AU - Bryce, J.

AU - Chetter, I.

AU - Ettles, D.

AU - Lakshminarayan, R.

AU - Mitchelsonm, K.

AU - Rhymes, C.

AU - Robinson, G.

AU - Scott, P.

AU - Vickers, A.

AU - Baht, H.

AU - Balogun, I.

AU - Burger, I.

AU - Cowie, L.

AU - Gunathilagan, G.

AU - Hargroves, D.

AU - Insall, R.

AU - Jones, S.

AU - Rudenko, H.

AU - Senaratne, J.

AU - Thomas, G.

AU - Thomson, A.

AU - Enevoldson, P.

AU - Nahser, H.

AU - O'Brian, I.

AU - Torella, F.

AU - Watling, D.

AU - White, R.

AU - Clifton, A.

AU - Eley, C.

AU - Khanom, N.

AU - O'Reilly, J.

AU - Pereira, A.

AU - Bicknell, C.

AU - Cheshire, N.

AU - Gibbs, R.

AU - Hamady, M.

AU - James, A.

AU - Jenkins, M.

AU - Lacey, A.

AU - Mireskandari, M.

AU - Sachs, T.

AU - Wolfe, J.

AU - Hardy, D.

AU - Justin, F.

AU - Phiri, L.

AU - Sekaran, L.

AU - Sethuraman, S.

AU - Tate, L.

AU - Akyea-Mensah, J.

AU - Chrisopoulou, A.

AU - Smyth, J. V.

AU - Nichol, I.

AU - Parry, A.

AU - Young, G.

AU - Clarke, M.

AU - Davis, M.

AU - Dixit, A.

AU - Dyker, A.

AU - Ford, G.

AU - Jackson, R.

AU - Kappadath, S.

AU - Lambert, D.

AU - Lees, T.

AU - Louw, S.

AU - Macdonald, S.

AU - Parr, N.

AU - Stansby, G.

AU - Wales, L.

AU - Wealleans, V.

AU - Wilson, L.

AU - Wyatt, M.

AU - Dorman, P.

AU - Hughes, A.

AU - Jones, D.

AU - Mendelow, A. D.

AU - Rodgers, H.

AU - MacSweeney, S.

AU - McConachie, N.

AU - Southam, A.

AU - Sunman, W.

AU - Briley, D.

AU - Darby, C.

AU - Handa, A.

AU - Hands, L.

AU - Kuker, W.

AU - Michael, K.

AU - Perkins, J.

AU - Schulz, U.

AU - Smith, D.

AU - Teal, R.

AU - Donnelly, M.

AU - D'Souza, S.

AU - Asehosem Egun, A.

AU - Gregory, B.

AU - Kelly, C.

AU - Punekar, S.

AU - Raj, S.

AU - Seriki, D.

AU - Thomson, G.

AU - Beard, J.

AU - Cleveland, T.

AU - Humphreys, J.

AU - Jenkins, A.

AU - King, C.

AU - Lonsdale, R.

AU - Nair, R.

AU - Nawaz, S.

AU - Okhuoya, F.

AU - Turner, D.

AU - Venables, G.

AU - Brown, J.

AU - Durairajan, R.

AU - Guyler, P.

AU - Harman, P.

AU - Jakeways, M.

AU - Khuoge, C.

AU - Kundu, A.

AU - Loganathan, T.

AU - Sinha, D.

AU - Thompson, V.

AU - Tysoe, S.

AU - Barer, [No Value]

AU - Brown, A.

AU - Crawford, S.

AU - Dunlop, P.

AU - Majmudar, [No Value]

AU - Mitchell, D.

AU - O'Brien, [No Value]

AU - O'Connell, [No Value]

AU - Scott, [No Value]

AU - Vetrivel, S.

AU - Ashleigh, R.

AU - Butterfield, S.

AU - Gamble, G.

AU - Ghosh, J.

AU - McCollum, C.

AU - Welch, M.

AU - Welsh, S.

AU - Kazan, V.

AU - Nazzal, M.

AU - Ramsey-Williams, V.

PY - 2013/11

Y1 - 2013/11

N2 - Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362.

AB - Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362.

KW - Carotid artery stenosis

KW - Carotid artery stenting

KW - Carotid endarterectomy

KW - Randomized controlled trial

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=84886726932&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886726932&partnerID=8YFLogxK

U2 - 10.1016/j.ejvs.2013.07.020

DO - 10.1016/j.ejvs.2013.07.020

M3 - Article

C2 - 24051108

AN - SCOPUS:84886726932

VL - 46

SP - 510

EP - 518

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 5

ER -