Carotid Endarterectomy Versus Carotid Artery Stenting in Asymptomatic Patients



Status:Recruiting
Conditions:Cardiology
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:18 - Any
Updated:6/15/2017
Start Date:January 2008
End Date:December 2019
Contact:Alison Halliday
Email:acst@nds.ox.ac.uk
Phone:+ 44 1865 221 345

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Asymptomatic Carotid Surgery Trial-2 (ACST-2): an International Randomised Trial to Compare Carotid Endarterectomy With Carotid Artery Stenting to Prevent Stroke

The trial randomise patients with asymptomatic carotid artery narrowing in whom prompt
physical intervention is thought to be needed, but there there is still substantial
uncertainty shared by patient and doctor about whether surgery or stenting is the more
appropriate choice.

The study is looking at immediate risks (within one month)and at long term benefits


Inclusion Criteria:

- Carotid artery stenosis detectable by duplex ultrasound, with no ipsilateral carotid
territory symptoms(or none for some months) and no previous procedure done on it,
which might well need procedural treatment now with CEA or CAS.

- Already started any appropriate medical treatment (eg, statin, aspirin etc), and
already recovered from any necessary coronary procedures (eg, CABG)

- Patient seems fit and willing for follow-up in person (at 1 month) and by annual
letter (for at least 5 years)

- Investigations show that both procedures (CEA and CAS) appear to be practicable and
appropriate

- Some type of angiography (eg, MRA or CTA) has already been done that has shown that
CEA and CAS would both be anatomically practicable.

- Doctor and patient both substantially uncertain about whether to treat with CEA or
CAS, and the doctor sees no clear indication/contra-indication for either procedure

Exclusion Criteria:

- Small likelihood of worthwhile benefit (eg, very low risk of stroke because stenosis
is very minor, or major co-morbidity or life-threatening disease, such as advanced
cancer)

- Unsuitable for one or other procedure (eg, stenosis at carotid siphon that is
inaccessible for CEA, or complex vasculature below the stenosis that would hinder
CAS, or patient unfit for major surgery)
We found this trial at
2
sites
?
mi
from
Antwerp,
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?
mi
from
Toledo, OH
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