Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 5;7(7):CD015499.
doi: 10.1002/14651858.CD015499.

Carotid revascularisation versus medical treatment for asymptomatic carotid artery stenosis

Tao Wang  1 , Xinyi Sun  1 , Xue Wang  2 , Yiding Feng  1 , Kun Yang  3 , Jie Wang  1 , Ran Xu  1 , Haozhi Gong  1 , Jichang Luo  1 , Adam A Dmytriw  4 , Liqun Jiao  1   5 , Yan Ma  1
Affiliations

Carotid revascularisation versus medical treatment for asymptomatic carotid artery stenosis

Tao Wang et al. Cochrane Database Syst Rev. .

Abstract

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the safety and efficacy of carotid revascularisation plus best medical treatment with best medical treatment alone in people with asymptomatic carotid artery stenosis.

PubMed Disclaimer

Conflict of interest statement

All review authors: no known conflicts of interest

Similar articles

See all similar articles

References

Additional references

Abbott 2009
    1. Abbott AL. Medical (non-surgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis. Stroke 2009;40:E573–83. - PubMed
Abbott 2015
    1. Abbott AL, Paraskevas KI, Kakkos SK, Golledge J, Eckstein HH, Diaz-Sandoval LJ, et al. Systematic review of guidelines for the management of asymptomatic and symptomatic carotid stenosis. Stroke 2015;46:3288-­301. - PubMed
Aboyans 2018
    1. Aboyans V, Ricco J-B, Bartelink M-L, Björck M, Brodmann M, Cohnert T, et al. 2017 European Society of Cardiology guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery. European Heart Journal 2018;39(9):763-816. - PubMed
AbuRahma 2022
    1. AbuRahma AF, Avgerinos ED, Chang RW, Darling RC 3rd, Duncan AA, Forbes TL, et al. Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease. Journal of Vascular Surgery 2022;75(1S):4S-22S. - PubMed
Balestroni 2012
    1. Balestroni G, Giorgio B. EuroQol-5D (EQ-5D): an instrument for measuring quality of life. Monaldi Archives for Chest Disease 2012;78(3):155-9. - PubMed
Bonati 2021
    1. Bonati LH, Kakkos S, Berkefeld J, Borst GJ, Bulbulia R, Halliday A, et al. European Stroke Organisation guideline on endarterectomy and stenting for carotid artery stenosis. European Stroke Journal 2021;6(2):I-XLVII. - PMC - PubMed
Brott 2010
    1. Brott TG, Hobson RW, Howard G, Roubin GS, Clark WM, Brooks W, et al. Stenting versus endarterectomy for treatment of carotid artery stenosis. New England Journal of Medicine 2010;363(1):11-23. - PMC - PubMed
Büchter 2021
    1. Büchter RB, Weise A, Pieper D. Reporting of methods to prepare, pilot and perform data extraction in systematic reviews: analysis of a sample of 152 Cochrane and non-Cochrane reviews. BMC Medical Research Methodology 2021;21(1):240. - PMC - PubMed
Coelho 2023
    1. Coelho A, Borst GJ. Timing of carotid intervention in symptomatic carotid artery stenosis: a topical review. Journal of Cardiovascular Surgery 2023;64(3):287-96. - PubMed
Columbo 2021
    1. Columbo JA, Martinez-Camblor P, O'Malley AJ, Stone DH, Kashyap VS, Powell RJ, et al. Association of adoption of transcarotid artery revascularization with center-level perioperative outcomes. JAMA Network Open 2021;4(2):e2037885. - PMC - PubMed
De Weerd 2010
    1. De Weerd M, Greving JP, Hedblad B, Lorenz MW, Mathiesen EB, O'Leary DH, et al. Prevalence of asymptomatic carotid artery stenosis in the general population an individual participant data meta-analysis. Stroke 2010;41(6):1294-7. - PMC - PubMed
Deeks 2023
    1. Deeks JJ, Higgins JP, Altman DG, editors. Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
Eastcott 1954
    1. Eastcott HH, Pickering GW, Rob CG. Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplegia. Lancet 1954;264:994–6. - PubMed
Easton 2009
    1. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al. Definition and evaluation of transient ischemic attack. Stroke 2009;40(6):2276-93. - PubMed
Feigin 2022
    1. Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global stroke fact sheet. International Journal of Stroke 2022;17(1):18-29. - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Version accessed 3 March 2020. Hamilton (ON): McMaster University (developed by Evidence Prime). Available at gradepro.org.
Grant 2003
    1. Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD, Bluth EI, et al. Carotid artery stenosis: gray-scale and Doppler US diagnosis - Society of Radiologists in Ultrasound Consensus Conference. Radiology 2003;229(2):340-6. - PubMed
Gurm 2008
    1. Gurm HS, Yadav JS, Fayad P, Katzen BT, Mishkel GJ, Bajwa TK, et al. Long-term results of carotid stenting versus endarterectomy in high-risk patients. New England Journal of Medicine 2008;358:1572–9. - PubMed
Guyot 2012
    1. Guyot P, Ades AE, Ouwens MJ, Welton NJ. Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves. BMC Medical Research Methodology 2012;12:9. - PMC - PubMed
Halliday 2004
    1. Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, et al. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 2004;363:1491–502. - PubMed
Halliday 2021
    1. Halliday A, Bulbulia R, Bonati LH, Chester J, Cradduck-Bamford A, Peto R, et al. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet 2021;398(10305):1065-73. - PMC - PubMed
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Higgins 2023
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
Howard 2021
    1. Howard DP, Gaziano L, Rothwell PM, Oxford Vascular Study. Risk of stroke in relation to degree of asymptomatic carotid stenosis: a population-based cohort study, systematic review, and meta-analysis. Lancet Neurology 2021;20(3):193-202. - PMC - PubMed
Intercollegiate Stroke Working Party 2023
    1. Intercollegiate Stroke Working Party. National clinical guideline for stroke for the UK and Ireland; May 2023. Available at: www.strokeguideline.org 2023.
Kashyap 2020
    1. Kashyap VS, Schneider P A, Foteh M, Motaganahalli R, Shah R, Eckstein HH, et al. Early outcomes in the ROADSTER 2 study of transcarotid artery revascularization in patients with significant carotid artery disease. Stroke 2020;51(9):2620-9. - PubMed
Keyhani 2020
    1. Keyhani S, Cheng EM, Hoggatt KJ, Austin PC, Madden E, Hebert PL, et al. Comparative effectiveness of carotid endarterectomy vs initial medical therapy in patients with asymptomatic carotid stenosis. JAMA Neurology 2020;77(9):1110-21. - PMC - PubMed
Keyhani 2022
    1. Keyhani S, Cheng EM, Hoggatt K, Austin PC, Madden E, Hebert PL, et al. Comparative effectiveness of carotid stenting to medical therapy among patients with asymptomatic carotid stenosis. Stroke 2022;53(4):1157-66. - PMC - PubMed
Kim 2023
    1. Kim HW, Regenhardt RW, D'Amato SA, Nahhas MI, Dmytriw AA, Hirsch JA, et al. Asymptomatic carotid artery stenosis: a summary of current state of evidence for revascularization and emerging high-risk features. Journal of Neurointerventional Surgery 2023;15(7):717-22. - PubMed
Kwolek 2015
    1. Kwolek CJ, Jaff MR, Leal JI, Hopkins LN, Shah RM, Hanover TM, et al. Results of the ROADSTER multicenter trial of transcarotid stenting with dynamic flow reversal. Journal of Vascular Surgery 2015;62:1227–34. - PubMed
Lefebvre 2023
    1. Lefebvre C, Glanville J, Briscoe S, Featherstone R, Littlewood A, Metzendorf M-I, et al. Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated October 2023). Available from www.training.cochrane.org/handbook.
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine 2009;6(7):e1000100. - PMC - PubMed
Malas 2022
    1. Malas MB, Dakour-Aridi H, Kashyap VS, Eldrup-Jorgensen J, Wang GJ, Motaganahalli RL, et al. Trans-carotid revascularization with dynamic flow reversal versus carotid endarterectomy in the vascular quality initiative surveillance project. Annals of Surgery 2022;276(2):398-403. - PubMed
Moresoli 2017
    1. Moresoli P, Habib B, Reynier P, Secrest MH, Eisenberg MJ, Filion KB. Carotid stenting versus endarterectomy for asymptomatic carotid artery stenosis: a systematic review and meta-analysis. Stroke 2017;48:2150–7. - PubMed
Naylor 2018
    1. Naylor AR, Ricco JB, Borst GJ, Debus S, Haro J, Halliday A, et al. Editor's choice - management of atherosclerotic carotidand vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). European Journal of Vascular and Endovascular Surgery 2018;55(1):3-81. - PubMed
Naylor 2023
    1. Naylor R, Rantner B, Ancetti S, Borst GJ, De Carlo M, Halliday A, et al, ESVS Guidelines Committee, Document Reviewers, . Editor's choice - European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease. European Journal of Vascular and Endovascular Surgery 2023;65(1):7-111. - PubMed
Reiff 2022
    1. Reiff T, Eckstein HH, Mansmann U, Jansen O, Fraedrich G, et al (SPACE-2 Investigators). Carotid endarterectomy or stenting or best medical treatment alone for moderate-to-severe asymptomatic carotid artery stenosis: 5-year results of a multicentre, randomised controlled trial. Lancet Neurology 2022;21(10):877-8. - PubMed
RevMan 2024 [Computer program]
    1. Review Manager (RevMan). Version 7.14.1. The Cochrane Collaboration, 2024. Available at revman.cochrane.org.
Roffi 2009
    1. Roffi M, Mukherjee D, Clair DG. Carotid artery stenting vs endarterectomy. European Heart Journal 2009;30(22):2693–704. - PubMed
Rosenfield 2016
    1. Rosenfield K, Matsumura JS, Chaturvedi S, Riles T, Ansel GM, Metzger DC, et al. Randomized trial of stent versus surgery for asymptomatic carotid stenosis. New England Journal of Medicine 2016;374:1011–20. - PubMed
Sardar 2017
    1. Sardar P, Chatterjee S, Aronow HD, Kundu A, Ramchand P, Mukherjee D, et al. Carotid artery stenting versus endarterectomy for stroke prevention: a meta-analysis of clinical trials. Journal of the American College of Cardiology 2017;69:2266–75. - PubMed
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editor(s). Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach (updated October 2013). GRADE Working Group, 2013. Available from gdt.guidelinedevelopment.org/app/handbook/handbook.html.
Tierney 2007
    1. Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 2007;8:16. - PMC - PubMed
Walker 1995
    1. Walker MD. Endarterectomy for asymptomatic carotid artery stenosis. Journal of the American Medical Association 1995;273:1421–8.
Wang 2022
    1. Wang J, Bai X, Wang T, Dmytriw AA, Patel AB, Jiao L, et al. Carotid stenting versus endarterectomy for asymptomatic carotid artery stenosis: a systematic review and meta-analysis. Stroke 2022;53:3047-54. - PubMed
Ware 2000
    1. Ware JE Jr. SF-36 health survey update. Spine 2000;25(24):3130-9. - PubMed

LinkOut - more resources