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PubMed
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Stroke Interventions in Clinical Trials
Printable Version
Endarterectomy, carotid
CEA Carotid endarterectomy

Action
Surgical therapy to remove atherosclerotic plaque in narrowed carotid arteries.

Status
Major symptomatic and asymptomatic trials completed - see published studies. Clear benefit of endarterectomy in secondary prevention for symptomatic patients with >70% stenosis. Potential value of surgery for 50-69% (symptomatic) or 60-99% (asymptomatic) is smaller and depends on surgical morbidity.

Trial(s)
  = Ongoing
  = Completed

ACAS Asymptomatic Carotid Atherosclerosis Study
ACE Aspirin and Carotid Endarterectomy Trial
ACST Asymptomatic Carotid Surgery Trial
ACT I Carotid Stenting vs. Surgery of Severe Carotid Artery Disease and Stroke Prevention in Asymptomatic Patients
Carotid Artery Stenting vs. Carotid Endarterectomy
Carotid Endarterectomy and Contralateral Carotid Occlusion
CASANOVA Carotid Artery Stenosis with Asymptomatic Narrowing: Operation Versus Aspirin
CAVATAS Carotid and Vertebral Transluminal Angioplasty Study
CREST Carotid Revascularization Endarterectomy vs Stent Trial
ECST European Carotid Surgery Trial
EVA-3S Endarterectomy Versus Angioplasty in Patients with Severe Symptomatic Carotid Stenosis
GALA General anaesthetic versus local anaesthetic for carotid surgery
ICSS (CAVATAS-2) International Carotid Stenting Study
MACE Mayo Asymptomatic Carotid Endarterectomy Study Group
NASCET North American Symptomatic Carotid Endarterectomy Trial
Prospective Randomized Trial of Carotid Endarterectomy Contralateral to Carotid Artery Occlusion
Role of carotid endarterectomy in asymptomatic carotid stenosis: a Veterans Administration Cooperative Study.
SAPPHIRE Stenting and Angioplasty with Protection in Patients and HIgh Risk for Endarterectomy
Silent Cerebral Infarcts After Carotid Endarterectomy Or Stenting And The Risk Of Cognitive Decline
SPACE Stent-protected Percutaneous Angioplasty of the Carotid vs. Endarterectomy
VACSP 309 Carotid Endarterectomy and Prevention of Cerebral Ischemia in Symptomatic Carotid Stenosis

Web Links and Publications
Note: This is an abridged publications list. Click on a clinical trial name above for a full list of publications resulting from that trial.

Carotid endarterectomy for symptomatic carotid stenosis.
Cochrane Database Syst Rev. 2000;(2):CD001081.

Carotid endarterectomy for asymptomatic carotid stenosis.
Cochrane Database Systematic Reviews 2000;(2):CD001923.

Low-dose and high-dose acetylsalicylic acid for patients undergoing carotid endarterectomy: a randomised controlled trial. ASA and Carotid Endarterectomy (ACE) Trial Collaborators.
Lancet. 1999 Jun 26;353(9171):2179-84.

Risk of stroke in the distribution of an asymptomatic carotid artery. The European Carotid Surgery Trialists Collaborative Group.
Lancet 1995 Jan 28;345(8944):209-12

Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. The Veterans Affairs Cooperative Study Group.
N Engl J Med 1993 Jan 28;328(4):221-7.

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