European Journal of Vascular & Endovascular Surgery
Volume 37, Issue 6 , Pages 625-632 , June 2009

Who Benefits Most from Intervention for Asymptomatic Carotid Stenosis: Patients or Professionals?

  • A.R. Naylor

      Affiliations

    • The Department of Vascular Surgery at Leicester Royal Infirmary, Leicester, UK
    • Corresponding Author InformationCorresponding author. Department of Vascular Surgery, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK. Tel.: +44 116 252 3252; fax: +44 116 252 3179.
    • ,
  • P.A. Gaines

      Affiliations

    • The Sheffield Vascular Institute, Northern General Hospital, Sheffield, UK
    • ,
  • P.M. Rothwell

      Affiliations

    • The Stroke Prevention Research Unit, University Department of Clinical Neurology, the John Radcliffe Hospital, Oxford, UK

Received 16 January 2009 ,Accepted 23 January 2009.

References 

  1. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study . Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–1428
  2. Asymptomatic Carotid Surgery Trial Collaborators. The MRC Asymptomatic Carotid Surgery Trial (ACST): carotid endarterectomy prevents disabling and fatal carotid territory strokes. Lancet. 2004;363:1491–1502
  3. http://www.fly2doc.com/public/Text.php?text_id=88
  4. McPhee JT, Schanzer A, Messina LM, Eslami MH. Carotid artery stenting has increased rates of post-procedure stroke, death and resource utilization than does carotid endarterectomy in the United States 2005. J Vasc Surg. 2008;48:1442–1450
  5. 2008 Great Britain and Ireland Carotid Endarterectomy Audit: Generic Trust Report. http://www.vascularsociety.org.uk.
  6. Endovasculaire behandeling van Carotisstenose. KCE Reports vol. 13A. Federaal Kenniscentrum voor de Gezondheidszorg, Centre Federal d'Expertise des Soins de Sante; 2005.
  7. Barnett HJM, Eliasziw M, Meldrum HE, Taylor DW. Do the facts and figures warrant a tenfold increase in the performance of carotid endarterectomy on asymptomatic patients?. Neurology. 1996;46:603–608
  8. Perry JR, Szalai JP, Norris JW. Consensus against both endarterectomy and routine screening for asymptomatic carotid artery stenosis: The Canadian Stroke Consortium. Arch Neurol. 1997;54:25–28
  9. Chaturvedi S. Should the multicenter carotid endarterectomy trials be repeated?. Arch Neurol. 2003;60:774–775
  10. Abbott A. Asymptomatic carotid artery stenosis: it's time to stop operating. Nat Clin Pract Neurol. 2008;4:4–5
  11. http://www.nejm.org/clinical%2Ddecisions/20080410/#commentbox
  12. Naylor AR, Rothwell PM, Bell PRF. Overview of the principal results and secondary analyses from the European and the North American randomised trials of carotid endarterectomy. Eur J Vasc Endovasc Surg. 2003;26:115–129
  13. Hankey GJ. Asymptomatic carotid stenosis: how should it be managed?. Med J Aust. 1995;163:197–200
  14. Naylor AR. Time is brain!. Surgeon. 2007;5:23–30
  15. http://www.vascularweb.org/profesionals/vascular_specialist/vol4/number3/newspaper_11_43893_43896.html
  16. Kresowik TF, Bratzler DW, Kresowik RA. Multistate improvement in process and outcomes of carotid endarterectomy. J Vasc Surg. 2004;39:372–380
  17. Wholey MH, Barbato JE, Al-Khoury GE. Treatment of asymptomatic carotid disease with stenting: Pro. Semin Vasc Surg. 2008;21:95–99
  18. Norris JW, Zhu CZ, Bornstein NM, Chambers BR. Vascular risks of asymptomatic carotid disease. Stroke. 1991;22:1485–1490
  19. Autret A, Pourcelot L, Saudeau D, Marchal C, Bertrand P, de Boisvilliers S. Stroke risk in patients with carotid stenosis. Lancet. 1987;888–890
  20. O'Holleran LW, Kennelly MM, McClurken M, Johnson JM. Natural history of asymptomatic carotid plaque: five year follow-up study. Am J Surg. 1987;154:659–662
  21. Bock RW, Gray-Weale AC, Mock PA, App SM, Robinson DA, Irwig L, et al. The natural history of asymptomatic carotid artery disease. J Vasc Surg. 1993;17:160–169
  22. Mansour MA, Mattos MA, Faught WE, Hodgson KJ, Barkmeier LD, Ramsey DE, et al. The natural history of moderate 50–79% internal carotid artry stenosis in symptomatic, non-hemispheric and asymptomatic patients. J Vasc Surg. 1995;21:346–357
  23. Rockman CB, Riles TS, Lamparello PJ, Giangola G, Adelman MA, Stone D, et al. Natural history and management of the asymptomatic, moderately stenosed internal carotid artery. J Vasc Surg. 1997;25:423–431
  24. Shanik GD, Moore DJ, Leahy A, Grouden MC, Colgan MP. Asymptomatic carotid stenosis: a benign lesion?. Eur J Vasc Surg. 1992;6:10–15
  25. Hobson RW, Weiss DG, Fields WS, Goldstone J, Moore WS, Towne JB. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis: the Veterans Affairs Co-operative Study Group. NEJM. 1993;345:209–212
  26. Satiani B, Porter RM, Biggers KM, Das BM. Natural history of non-operated significant carotid stenosis. Ann Vasc Surg. 1988;2:271–278
  27. Ellis MR, Franks PJ, Cuming R, Powell JT, Greenhalgh RM. Prevalence, progression and natural history of asymptomatic carotid stenosis: is there a place for carotid endarterectomy?. Eur J Vasc Surg. 1992;6:172–177
  28. Mackey AE, Abrahamowicz M, Langlois Y, Battista R, Simard D, Bourque F. Outcome of asymptomatic patients with carotid disease. Neurology. 1997;48:896–903
  29. Ford CS, Frye JL, Toole JF, Lefkowitz D. Asymptomatic carotid bruit and stenosis: a prospective follow up study. Arch Neurol. 1986;43:219–222
  30. Hennerici M, Hulsbomer HB, Hefter H, Lammerts D, Rautenberg W. Natural history of asymptomatic extracranial arterial disease: results of a long term prospective study. Brain. 1987;110:777–791
  31. Nadareishvili ZG, Rothwell PM, Beletsky V, Pagniello A, Norris JW. Long term risk of stroke and other vascular events in patients with asymptomatic carotid stenosis. Arch Neurol. 2002;59:1162–1166
  32. Goessens BMB, Visseran FLJ, Kappelle J, Algra A, van der Graaf Y for the SMART Study Group. Asymptomatic carotid artery stenosis and the risk of new vascular events in patients with manifest arterial disease: the SMART Study. Stroke. 2007;38:1470–1475
  33. Inzitari D, Eliasziw M, Gates P, Sharpe BL, Chan RK, Meldrum HE, et al. The causes and risk of stroke in patients with asymptomatic internal carotid artery stenosis: North American Symptomatic Carotid Endarterectomy Trial Collaborators. NEJM. 2000;342:1693–1700
  34. Abbott AL, Chambers BR, Stork JL, Levi CR, Bladin CF, Donnan GA. Embolic signals and prediction of ipsilateral stroke or transient ischaemic attack in asymptomatic carotid stenosis: a multicentre Prospective Cohort Study. Stroke. 2005;36:1128–1133
  35. Tong Y, Royle J. Outcome of patients with symptomless carotid bruits: a prospective study. Cardiovasc Surg. 1996;4:174–180
  36. Dick P, Sherif C, Sabeti S, Amighi J, Minar E, Schillinger M. Gender differences in outcome of conservatively treated patients with asymptomatic high grade carotid stenosis. Stroke. 2005;36:1178–1183
  37. European Carotid Surgery Trialists Collaborative Group. Risk of stroke in the distribution of an asymptomatic carotid artery. Lancet. 1995;345:209–212
  38. Longstreth WT, Shemanski L, Lefkowitz D, O'Leary DH, Polak JF, Wolfson SK. Asymptomatic internal carotid artery stenosis defined by ultrasound and the risk of subsequent stroke in the elderly. The Cardiovascular Health Study. Stroke. 1998;29:2371–2376
  39. Johnson JM, Kennelly MM, Decesare D, Morgan S, Sparrow A. Natural history of asymptomatic carotid plaque. Arch Surg. 1985;120:1010–1012
  40. Chambers BR, Norris JW. Outcome in patients with asymptomatic neck bruit. NEJM. 1986;315:860–865
  41. Meissner I, Wiebers DO, Whisnant JP, O'Fallon WM. The natural history of asymptomatic carotid artery occlusive lesions. JAMA. 1987;258:2704–2707
  42. Mess W, Steinke W, Rautenberg W, Hennerici M. Asymptomatic extracranial arterial disease. Cerebrovasc Dis. 1992;2:199
  43. Bogousslavsky J, Despland PA, Regli F. Asymptomatic tight stenosis of the internal carotid artery: long term prognosis. Neurology. 1986;36:861–863
  44. Abbott AL, Bladin CF, Levi CR, Chambers BR. What should we do with asymptomatic carotid stenosis?. Int J Stroke. 2007;2:27–39
  45. Touze E. Natural history of asymptomatic carotid stenosis. Revue Neurologique. 2008;164:793–800
  46. Rijbroek A, Wisselink W, Vriens EM, Barkhof F, Lammertsma AA, Rauwerda JA. Asymptomatic carotid artery stenosis: past, present and future. Eur Neurol. 2006;56:139–154
  47. Nicolaides AN, Kakkos SK, Griffin M, Sabetai M, Dhanjil S, Tegos T, et al. for the ACSRS Study Group. Severity of asymptomatic carotid stenosis and risk of ipsilateral hemispheric ischaemic events: results from the ACSRS. Eur J Vasc Endovasc Surg. 2005;30:275–284
  48. Young B, Moore WS, Robertson JT, Toole JF, Ernst CB, Cohen SN, et al. An analysis of peri-operative surgical mortality and morbidity in the Asymptomatic Carotid Atherosclerosis Study. Stroke. 1996;27:2216–2224
  49. Rothwell PM. ACST: which subgroups will benefit most from carotid endarterectomy. Lancet. 2004;364:1122–1123
  50. Chambers BR, Donnan GA. Carotid endarterectomy for asymptomatic carotid stenosis. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD001923. DOI 10.1002/14651858. CD001923.pub2.
  51. Arazi HC, Capparelli FJ, Linetzky B, Rebolledo FP, Augustovski F, Wainsztein NA. Carotid endarterectomy in asymptomatic stenosis: a decision analysis. Clin Neurol Neurosurg. 2008;110:472–479
  52. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20536 high-risk individuals: a randomised placebo controlled trial. Lancet. 2002;360:7–22
  53. Cote R, Battista RN, Abrahamowicz M, Langlois Y, Bourque F, Mackey A. Lack of effect of aspirin in asymptomatic patients with carotid bruits and substantial carotid narrowing: The Asymptomatic Cervical Bruit Study Group. Ann Int Med. 1995;123:649–655
  54. Spence DJ, Tamayo A, Lownie SP, Ng WP, Ferguson GG. Absence of microemboli on transcranial Doppler identifies low risk patients with asymptomatic carotid stenosis. Stroke. 2005;36:2373–2378
  55. The ACES Investigators. The Asymptomatic Carotid Emboli Study (ACES): study design and baseline results. Int J Stroke, in press.
  56. Kakkos S, Sabetai M, Tegos T, Stevens J, Thomas D, Griffin M, et al. Silent embolic infarcts on computed tomography brain scans and risk of ipsilateral hemispheric events in patients with asymptomatic internal carotid artery stenosis. J Vasc Surg, in press.
  57. Altaf N, MacSweeney ST, Gladman J, Auer DP. Carotid intraplaque haemorrhage predicts recurrent symptoms in patients with high-grade carotid stenosis. Stroke. 2007;38:1633–1635
  58. Nicolaides AN, Kakkos S, Griffin M, Sabetai M, Dhanjil S, Thomas DJ, et al. Effect of image normalisation on carotid plaque classification and the risk of ipsilateral ischemic events: Results from the Asymptomatic Carotid Stenosis and Risk of Stroke Study. Vascular. 2005;13:211

PII: S1078-5884(09)00131-2

doi: 10.1016/j.ejvs.2009.01.026

European Journal of Vascular & Endovascular Surgery
Volume 37, Issue 6 , Pages 625-632 , June 2009

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