• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

No difference between stenting versus surgery for asymptomatic carotid stenosis: The ACT Trial

byShaidah Deghan, MSc. MD
March 17, 2016
in Cardiology, Imaging and Intervention, Surgery
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. There was no significant difference between stenting versus carotid endarterectomy (CEA) for asymptomatic patients with carotid stenosis that were not at high risk for post-operative complications.

2. The study was discontinued prior to it reaching the number needed for 80% certainty due to the extended period of time for enrollment. 

Evidence Rating Level: 1 (Excellent)      

Study Rundown: Prior studies had shown that among asymptomatic patients with carotid-artery stenosis of greater than 60% of the diameter of the artery, the risk of stroke or death was lower when immediate CEA was performed via surgery. However, revascularization can also be performed by means of stenting and removing the emboli. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) found no significant difference between stenting and surgery. However, the study was not sufficiently powered. The Asymptomatic Carotid Trial (ACT) I study was prospective multicenter trial aimed to compare the outcomes of CEA versus stenting in asymptomatic severe carotid-artery stenosis patients that were at risk for surgical complications. It randomly assigned patients in a 3:1 ratio to undergo stenting or CEA. The results showed that at one-year CEA was not superior compared to stenting. There were no significant differences between the two procedures in regards to the rate of non-procedure-related stroke, all stroke, and survival at the 30 day to 5-year follow-up end point. The study is limited by a number of factors including termination prior to reaching the number needed for 80% certainty due to the long period of time it took for the study to enroll patients into the study.

Click to read the study, published today in NEJM

Relevant Reading: Stenting versus endarterectomy for treatment of carotid-artery stenosis

In-Depth [randomized controlled trial]:  A total of 1453 patients were randomly assigned to undergo stenting or CEA in a 3:1 ratio. There were no significant differences between the two groups in regards to baseline clinical characteristics. Patients were confirmed to be asymptomatic prior to randomization and neurological assessments took place before and on the day of the procedure, and at 1, 6, and 12 months up to 5 years after the procedure. The primary end point was the collection of death, stroke (ipsilateral or contralateral), major or minor, or MI during the 30 days after the procedure or ipsilateral stroke during the 365 days after the procedure. At 1 year, the event rate was 3.8% in the stenting group vs. 3.4% in the CEA group, with a between group difference of 0.4 percentage points. There was no significant difference between the rate of stroke or death within 30 days between the two groups (2.9% in the stenting group vs. 1.7% in the CEA group; p=0.33). From 30 days to 5 years there were no significant differences between the two groups in regards to the rate of freedom from ipsilateral stroke (97.8% in the stenting group vs. 97.3% in the CEA group; p=0.51). The overall 5-year stroke-free survival rate was similar between the two groups (93.1% in the stenting group vs. 94.7% in the CEA group; p=0.44).

RELATED REPORTS

Carotid artery stenting and carotid endarterectomy show similar efficacy for stroke prevention in high-risk carotid artery stenosis

Lower LDL associated with regression of pre-existing atherosclerotic lesions but not carotid plaque incidence

#VisualAbstact: Lower LDL associated with regression of pre-existing atherosclerotic lesions but not carotid plaque incidence

Image: PD

©2016 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: Carotid endarterectomycarotid stenosis
Previous Post

Rapid point-of-care TB test effective at reducing mortality in HIV positive patients

Next Post

Concussions associated with an increased risk of subsequent suicide

RelatedReports

2 Minute Medicine Rewind October 12 – 19, 2014
Cardiology

Carotid artery stenting and carotid endarterectomy show similar efficacy for stroke prevention in high-risk carotid artery stenosis

September 28, 2021
Chronic Disease

Lower LDL associated with regression of pre-existing atherosclerotic lesions but not carotid plaque incidence

July 7, 2020
#VisualAbstact: Lower LDL associated with regression of pre-existing atherosclerotic lesions but not carotid plaque incidence
StudyGraphics

#VisualAbstact: Lower LDL associated with regression of pre-existing atherosclerotic lesions but not carotid plaque incidence

July 7, 2020
High incidence of foreskin morbidity in uncircumcised males
Chronic Disease

Carotid endarterectomy vs initial medical therapy in asymptomatic carotid stenosis

June 11, 2020
Next Post
Shared decision-making tool for antidepressants improves patient and physician satisfaction

Concussions associated with an increased risk of subsequent suicide

Lower long-term IUD use among young women

LARC use associated with a lesser likelihood of condom use in teenage girls

Nivolumab may be effective in platinum-resistant ovarian cancer

Silicon microparticles may improve chemotherapeutic delivery to metastatic tumors in mice [PreClinical]

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Catheter ablation reduces rates of persistent atrial fibrillation and atrial tachyarrhythmia
  • Deep intronic FGF14 repeat expansion associated with late-onset cerebella ataxia
  • Plant-based diets may be associated with lower risk of aggressive prostate cancer
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options