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

ACST-2 Collaborative Group

Authors

ACST-2 Collaborative Group



Contributors

Alison Halliday
Other

Richard Bulbulia
Other

William Gray
Other

Ally Naughten
Other

Anne Den Hartog
Other

Antonella Delmestri
Other

Carol Wallis
Other

Stephanie Le Conte
Other

Sumaira Macdonald
Other

M. Hertoghs
Other

Djordje Radak
Other

Franco Nessi
Other

Giovanni Torsello
Other

Jeroen Hendriks
Other

Katarina Bjorses
Other

Lazar Davidovic
Other

Nicola Tusini
Other

Peter Gillgren
Other

Renato Casana
Other

Valerio Tolva
Other

Yvonne Bausback
Other

Ali Mehrzad
Other

Anders Gottsater
Other

Bernard Esisi
Other

P. Cras
Other

J.M.H. Hendriks
Other

P. Lauwers
Other

P. Van Schil
Other

L. De Jaegher
Other

P. Peeters
Other

J. Verbist
Other

D. Dendooven
Other

J. De Letter
Other

G. Vanhooren
Other

P. Astarci
Other

I. Capron
Other

C. Choghari
Other

F. Hammer
Other

V. Lacroix
Other

A. Peeters
Other

R. Verhelst
Other

M. Bosiers
Other

K. De Meester
Other

K. Deloose
Other

E. Van Buggenhout
Other

E. Vinck
Other

M. Geenens
Other

D. Hemelsoet
Other

I. Van Herzeele
Other

F. Vermassen
Other

G. De Koster
Other

Q. Desiron
Other

A. De Noordhout Maertens
Other

D. Malmendier
Other

M. Massoz
Other

G. Saad
Other

S. Cirelli
Other

P. Dormal
Other

P. Lerut
Other

E. Thues
Other

S. Coutts
Other

A. Demchuk
Other

M. Hill
Other

M. Hudon
Other

G. Klein
Other

M. McClelland
Other

W. Morrish
Other

G. Samis
Other

G. Sutherland
Other

T. Watson
Other

J. Wong
Other

Bao Liu
Other

Chang Wei Liu
Other

Abstract

ObjectivesACST-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.ResultsA 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%.ConclusionsEarly 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.

Citation

ACST-2 Collaborative Group. (2013). Status update and interim results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2). European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 46(5), 510-518. https://doi.org/10.1016/j.ejvs.2013.07.020

Journal Article Type Article
Acceptance Date Jul 27, 2013
Online Publication Date Sep 17, 2013
Publication Date 2013-11
Print ISSN 1078-5884
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 46
Issue 5
Pages 510-518
DOI https://doi.org/10.1016/j.ejvs.2013.07.020
Keywords Surgery; Cardiology and Cardiovascular Medicine
Public URL https://hull-repository.worktribe.com/output/432736

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