Editor's Choice - Systematic Review and Meta-Analysis of Very Urgent Carotid Intervention for Symptomatic Carotid Disease

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
David MilgromGeorge A Antoniou

Abstract

The optimum timing of carotid intervention for symptomatic carotid stenosis remains unclear. The objective was to investigate outcomes of very urgent (< 48 h from neurological event) in comparison to urgent (≥ 48 h from neurological event) carotid intervention for symptomatic carotid disease. A systematic literature review was carried out of randomised control trials (RCTs) and observational studies reporting peri-procedural outcomes of carotid intervention in relation to the length of time since the neurological event (PROSPERO registration number: CRD 42017075766). Ipsilateral stroke and death were defined as the primary outcome endpoints. Transient ischaemic attack (TIA) and myocardial infarction (MI) were secondary outcome parameters. Comparative outcomes were calculated and reported as dichotomous outcome measures using the odds ratio (OR) and associated 95% confidence interval (CI) for very urgent (< 48 h since neurological event) versus urgent (≥ 48 h) intervention. The combined overall effect size was calculated using a random effects model. Twelve observational studies and one RCT representing 5751 interventions, 5385 carotid endarterectomies (CEAs) and 366 carotid artery stenting (CAS) procedures, were included in qua...Continue Reading

Citations

Nov 26, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A RoussopoulouS N Vasdekis
Jan 3, 2019·European Heart Journal·Victor AboyansUNKNOWN ESC Working Group on Aorta and Peripheral Vascular Diseases
Mar 26, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Kaustubh LimayeSantiago Ortega-Gutierrez
Feb 23, 2020·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Stephen BallGeorge A Antoniou
Dec 5, 2018·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Vladimir T de Vasconcelos
Mar 28, 2019·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·George A AntoniouFrancesco Torella

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