Screening For Carotid Artery Stenosis: An Update of the Evidence. Table 1

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Table 1. Evidence Table for Randomized, Controlled Trials for Effectiveness of Surgery versus Medical Management for Asymptomatic Carotid Artery Stenosis^a

Study, Year (Reference)

Sample Characteristics

Mean Follow-up

30-Day Perioperative Complication Rate

5-Year Outcomes^b

Quality Rating

VACS, 1993³¹

n=444
MM group: 233
CEA group: 211

Mean age: 65 y
Men: 100%
White: 86% to 88%

48 mo

Stroke or death: 4.7%
MI: 1.9%

5-year incidence of any stroke and perioperative death:
MM group: 44.2%
CEA group: 41.2%
RR, 0.92 (95% CI, 0.69–1.22)

Fair

ACAS, 1995³²

n=1659
MM group: 834
CEA group: 825

Mean age: 67 y
Men: 66%
White: 94% to 95%

2.7 y

Stroke or death: 2.7%
MI: NR

By sex:
Women: 3.6%
Men: 1.7%

Rate of perioperative stroke or death and subsequent ipsilateral stroke:
MM group: 11%
CEA group: 5.1%
RRR, 53% (CI, 22% to 72%)
ARR, 5.9%

By sex:
Women: RRR, 17% (CI, .96% to 65%)
Men: RRR, 66% (CI, 36% to 82%)

By age:
<68 y: RRR, 0.60 (CI, 0.11 to 0.82)
>68 y: RRR, 0.43 (CI,.0.07 to 0.70)

Good

ACST, 2004³³

n=3120
MM group: 1560
CEA group: 1560

Mean age: 68 y
Men: 66%
White:NR

3.4 y

Stroke or death: 2.8%
MI: 0.6%

By sex:
Women: 3.1%
Men: 2.2%

By age:
<65 y: 2.4%
65–74 y: 2.3%
>75 y: 3.3%

5-year incidence of any stroke and perioperative death:
MM group: 11.8% (SE .1.00%)
CEA group: 6.4% (SE .0.70%)
ARR, 5.4% (CI, 2.96% to 7.75%)

5-year incidence of nonperioperative stroke:
By sex:
Women: ARR, 4.1% (CI, 0.74% to 7.41%)
Men: ARR, 8.2% (CI, 5.64% to 10.78%)

By age:
<65 y: ARR, 7.8% (CI, 4.28% to 11.31%)
65–74 y: ARR, 7.5% (CI, 4.67% to 10.30%)
>75 y: ARR, 3.3%

Good

^a. For further details on these studies, go to Appendix Table 3. ACAS = Asymptomatic Carotid Atherosclerosis Study; ACST = Asymptomatic Carotid Surgery Trial; ARR = absolute risk reduction; CEA = carotid endarterectomy; MI = myocardial infarction; MM = medical management; NR = not reported; RR = relative risk; RRR = relative risk reduction; VACS = Veterans Affairs Cooperative Study.
^b. Standard errors and 95% CIs are listed if they were reported in the studies.

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Table 1. Evidence Table for Randomized, Controlled Trials for Effectiveness of Surgery versus Medical Management for Asymptomatic Carotid Artery Stenosisa

Table 1. Evidence Table for Randomized, Controlled Trials for Effectiveness of Surgery versus Medical Management for Asymptomatic Carotid Artery Stenosis^a