Treatment of asymptomatic carotid artery stenosis: improvement of evidence with new SPACE-2 design necessary

Der Nervenarzt
T ReiffU Mansmann

Abstract

Asymptomatic carotid artery stenosis may be treated with carotid endarterectomy (CEA), carotid artery stenting (CAS) or with best medical treatment (BMT) only. Definitive and evidence-based treatment recommendations for one of these options are currently not possible. Studies showing an advantage of CEA over BMT alone do not meet current standards from a pharmacological point of view. On the other hand, more recent data point to a further stroke risk reduction using BMT according to current standards. Studies on carotid artery stenting as a third alternative treatment are partially insufficient, especially when comparing CAS with BMT. Initiated in 2009, the randomized, controlled, multicenter SPACE-2 trial is intended to answer the question about the best treatment option of asymptomatic carotid artery stenosis; however, to increase recruitment rates as a condition for the successful completion of this important study, the trial design had to be modified.

References

May 12, 2004·Lancet·A HallidayUNKNOWN MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group
Oct 8, 2004·The New England Journal of Medicine·Jay S YadavUNKNOWN Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators
Jun 10, 2006·Acta chirurgica Belgica·P Bell
Aug 20, 2009·International Journal of Stroke : Official Journal of the International Stroke Society·T ReiffUNKNOWN SPACE2-Study Group
May 28, 2010·The New England Journal of Medicine·Thomas G BrottUNKNOWN CREST Investigators
Oct 23, 2010·Stroke; a Journal of Cerebral Circulation·Karen L FurieUNKNOWN American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisci
Sep 6, 2011·Journal of Vascular Surgery·John J RicottaUNKNOWN Society for Vascular Surgery
Dec 14, 2011·Seminars in Vascular Surgery·Frank J Veith, Kosmas I Paraskevas
May 17, 2013·Der Internist·K Halbritter, N Weiss

❮ Previous
Next ❯

Citations

Dec 3, 2014·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·A Ross Naylor
Jun 16, 2016·Stroke; a Journal of Cerebral Circulation·Peter VanackerPatrik Michel

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.