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Stroke, Vol 22, 711-720, Copyright © 1991 by American Heart Association
Fifty North American centers have combined to evaluate the benefit of
carotid endarterectomy in randomized patients who have experienced symptoms
related to arteriosclerotic stenosis of the carotid artery and who have
received either best medical therapy alone or best medical therapy plus
carotid endarterectomy. The outcome events are nonfatal and fatal stroke or
death. A three-tier system identifies and adjudicates the type, severity,
and location of each stroke and the cause of any death. Data about patients
submitted to carotid endarterectomy outside the trial are compiled at the
Nonrandomized Data Center at the Mayo Clinic. Between December 27, 1987,
and October 1, 1990, 1,212 patients were randomized, 596 to medical
therapy, 616 to carotid endarterectomy. Cross-over from the medical to the
surgical arm has been low (4.2%). Patients eligible for the trial, but not
randomized totaled 1,044; their characteristics were similar to those
randomized so that, for the type of symptomatic patient in this study, our
conclusions about the benefit of carotid endarterectomy can be generalized.
Patients excluded by medical criteria totaled 679. Another 1,591 had
carotid endarterectomy, but either lacked the disease under study, were
asymptomatic, or received inadequate investigation to meet entry criteria.
We set sample size at 1,900 patients, with continuing enrollment. The
Monitoring Committee reviews at intervals the confidential analyses
performed on the groups with moderate (30-69%) and severe (70-99%)
stenosis. Stopping rules will be invoked for one or both groups if
unequivocal benefit or harm is identified.
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North American Symptomatic Carotid Endarterectomy Trial. Methods, patient characteristics, and progress
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J. Y. Streifler, M. Eliasziw, O. R. Benavente, S. Alamowitch, A. J. Fox, V. C. Hachinski, and H. J.M. Barnett Prognostic Importance of Leukoaraiosis in Patients With Symptomatic Internal Carotid Artery Stenosis Stroke, June 1, 2002; 33(6): 1651 - 1655. [Abstract] [Full Text] [PDF]
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L. Remonda, P. Senn, A. Barth, M. Arnold, K.-O. Lovblad, and G. Schroth Contrast-Enhanced 3D MR Angiography of the Carotid Artery: Comparison with Conventional Digital Subtraction Angiography AJNR Am. J. Neuroradiol., February 1, 2002; 23(2): 213 - 219. [Abstract] [Full Text] [PDF]
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 J. Ayerdi, L. N. Sampson, N. Deshmukh, A. Farid, and S. K. Gupta Carotid Endarterectomy in Patients with Renal Insufficiency: Should Selection Criteria be Different in Patients with Renal Insufficiency? Vascular and Endovascular Surgery, November 1, 2001; 35(6): 429 - 435. [Abstract] [PDF]
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N. Al-Mubarak, G. S. Roubin, J. J. Vitek, S. S. Iyer, G. New, and M. B. Leon Effect of the Distal-Balloon Protection System on Microembolization During Carotid Stenting Circulation, October 23, 2001; 104(17): 1999 - 2002. [Abstract] [Full Text] [PDF]
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O. Benavente, M. Eliasziw, J. Y. Streifler, A. J. Fox, H. J.M. Barnett, H. Meldrum, and the North American Symptomatic Carotid Endarterect Prognosis after Transient Monocular Blindness Associated with Carotid-Artery Stenosis N. Engl. J. Med., October 11, 2001; 345(15): 1084 - 1090. [Abstract] [Full Text] [PDF]
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S. Jander, M. Sitzer, A. Wendt, M. Schroeter, M. Buchkremer, M. Siebler, W. Muller, W. Sandmann, and G. Stoll Expression of Tissue Factor in High-Grade Carotid Artery Stenosis : Association With Plaque Destabilization Stroke, April 1, 2001; 32(4): 850 - 854. [Abstract] [Full Text] [PDF]
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D. A. Bluemke, A. E. Stillman, K. G. Bis, T. M. Grist, R. A. Baum, R. D’Agostino, E. S. Malden, J. A. Pierro, and E. K. Yucel Carotid MR Angiography: Phase II Study of Safety and Efficacy for MS-325 Radiology, April 1, 2001; 219(1): 114 - 122. [Abstract] [Full Text]
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M. Koga, K. Kimura, K. Minematsu, and T. Yamaguchi Diagnosis of Internal Carotid Artery Stenosis Greater than 70% with Power Doppler Duplex Sonography AJNR Am. J. Neuroradiol., February 1, 2001; 22(2): 413 - 417. [Abstract] [Full Text] [PDF]
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G. S. Roubin, G. New, S. S. Iyer, J. J. Vitek, N. Al-Mubarak, M. W. Liu, J. Yadav, C. Gomez, and R. E. Kuntz Immediate and Late Clinical Outcomes of Carotid Artery Stenting in Patients With Symptomatic and Asymptomatic Carotid Artery Stenosis : A 5-Year Prospective Analysis Circulation, January 30, 2001; 103(4): 532 - 537. [Abstract] [Full Text] [PDF]
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B.-W. Yoon, H.-J. Bae, D.-W. Kang, S.-H. Lee, K.-S. Hong, K.-B. Kim, B. J. Park, and J.-K. Roh Intracranial Cerebral Artery Disease as a Risk Factor for Central Nervous System Complications of Coronary Artery Bypass Graft Surgery Stroke, January 1, 2001; 32(1): 94 - 99. [Abstract] [Full Text] [PDF]
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J. H. III, S. B. Fain, J. T. Wald, P. H. Luetmer, C. H. Rydberg, D. J. Covarrubias, S. J. Riederer, M. A. Bernstein, R. D. Brown, F. B. Meyer, et al. Carotid Artery: Elliptic Centric Contrast-enhanced MR Angiography Compared with Conventional Angiography Radiology, January 1, 2001; 218(1): 138 - 143. [Abstract] [Full Text]
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R. D. Henderson, D. A. Steinman, M. Eliasziw, and H. J. M. Barnett Effect of Contralateral Carotid Artery Stenosis on Carotid Ultrasound Velocity Measurements Stroke, November 1, 2000; 31(11): 2636 - 2640. [Abstract] [Full Text] [PDF]
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C. C. Phatouros, R. T. Higashida, A. M. Malek, P. M. Meyers, T. E. Lempert, C. F. Dowd, and V. V. Halbach Carotid Artery Stent Placement for Atherosclerotic Disease: Rationale, Technique, and Current Status Radiology, October 1, 2000; 217(1): 26 - 41. [Abstract] [Full Text]
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M. Paciaroni, M. Eliasziw, B. L. Sharpe, L. J. Kappelle, S. Chaturvedi, H. Meldrum, and H. J.M. Barnett Long-Term Clinical and Angiographic Outcomes in Symptomatic Patients With 70% to 99% Carotid Artery Stenosis Stroke, September 1, 2000; 31(9): 2037 - 2042. [Abstract] [Full Text] [PDF]
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D. Inzitari, M. Eliasziw, P. Gates, B. L. Sharpe, R. K.T. Chan, H. E. Meldrum, H. J.M. Barnett, and The North American Symptomatic Carotid Endarterect The Causes and Risk of Stroke in Patients with Asymptomatic Internal-Carotid-Artery Stenosis N. Engl. J. Med., June 8, 2000; 342(23): 1693 - 1701. [Abstract] [Full Text] [PDF]
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D. Inzitari, M. Eliasziw, B. L. Sharpe, A. J. Fox, and H. J. M. Barnett Risk factors and outcome of patients with carotid artery stenosis presenting with lacunar stroke Neurology, February 8, 2000; 54(3): 660 - 660. [Abstract] [Full Text] [PDF]
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P. B. Gorelick Carotid Endarterectomy : Where Do We Draw the Line? Stroke, September 1, 1999; 30(9): 1745 - 1750. [Full Text] [PDF]
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G. G. Ferguson, M. Eliasziw, H. W. K. Barr, G. P. Clagett, R. W. Barnes, M. C. Wallace, D. W. Taylor, R. B. Haynes, J. W. Finan, V. C. Hachinski, et al. The North American Symptomatic Carotid Endarterectomy Trial : Surgical Results in 1415 Patients Stroke, September 1, 1999; 30(9): 1751 - 1758. [Abstract] [Full Text] [PDF]
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M. Paciaroni, M. Eliasziw, L. J. Kappelle, J. W. Finan, G. G. Ferguson, and H. J. M. Barnett Medical Complications Associated With Carotid Endarterectomy Stroke, September 1, 1999; 30(9): 1759 - 1763. [Abstract] [Full Text] [PDF]
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M. P. Spencer, C. Ranke, H.-J. Trappe, A. Creutzig, and H. Becker Standardization of Carotid Ultrasound • Response Stroke, June 1, 1999; 30(6): 1286 - 1295. [Full Text] [PDF]
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J. H. III, S. B. Fain, S. J. Riederer, A. H. Wilman, M. A. Bernstein, and R. F. Busse Carotid Arteries: Maximizing Arterial to Venous Contrast in Fluoroscopically Triggered Contrast-enhanced MR Angiography with Elliptic Centric View Ordering Radiology, April 1, 1999; 211(1): 265 - 273. [Abstract] [Full Text]
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T. Uehara, M. Tabuchi, and E. Mori Risk Factors for Silent Cerebral Infarcts in Subcortical White Matter and Basal Ganglia Stroke, February 1, 1999; 30(2): 378 - 382. [Abstract] [Full Text] [PDF]
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C. Ranke, A. Creutzig, H. Becker, and H.-J. Trappe Standardization of Carotid Ultrasound : A Hemodynamic Method to Normalize for Interindividual and Interequipment Variability Stroke, February 1, 1999; 30(2): 402 - 406. [Abstract] [Full Text] [PDF]
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L. Birincioglu, K. Arda, H. Bardakci, K. Ozberk, M. Bayazlt, T. Cumhur, O. Tasdemir, and K. Bayazit Carotid Disease in Patients Scheduled for Coronary Artery Bypass: Analysis of 678 Patients Angiology, January 1, 1999; 50(1): 9 - 19. [Abstract] [PDF]
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H. J.M. Barnett, D. W. Taylor, M. Eliasziw, A. J. Fox, G. G. Ferguson, R. B. Haynes, R. N. Rankin, G. P. Clagett, V. C. Hachinski, D. L. Sackett, et al. Benefit of Carotid Endarterectomy in Patients with Symptomatic Moderate or Severe Stenosis N. Engl. J. Med., November 12, 1998; 339(20): 1415 - 1425. [Abstract] [Full Text] [PDF]
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M. R. Lepore, W. D. Jordan Jr, W. S. Fisher, D. C. Voellinger, D. Redden, and H. A. McDowell Treatment of Recurrent Carotid Stenosis: Angioplasty with Stenting versus Reoperative Carotid Surgery Vascular and Endovascular Surgery, November 1, 1998; 32(6): 523 - 530. [Abstract] [PDF]
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T. Pohjasvaara, A. Leppavuori, I. Siira, R. Vataja, M. Kaste, and T. Erkinjuntti Frequency and Clinical Determinants of Poststroke Depression Stroke, November 1, 1998; 29(11): 2311 - 2317. [Abstract] [Full Text] [PDF]
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L. Valton, V. Larrue, A. P. le Traon, P. Massabuau, and G. Geraud Microembolic Signals and Risk of Early Recurrence in Patients With Stroke or Transient Ischemic Attack Stroke, October 1, 1998; 29(10): 2125 - 2128. [Abstract] [Full Text] [PDF]
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E. J. Russell Reply AJNR Am. J. Neuroradiol., August 1, 1998; 20(7): 1379 - 1381. [Full Text]
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S. Jander, M. Sitzer, R. Schumann, M. Schroeter, M. Siebler, H. Steinmetz, and G. Stoll Inflammation in High-Grade Carotid Stenosis : A Possible Role for Macrophages and T Cells in Plaque Destabilization Stroke, August 1, 1998; 29(8): 1625 - 1630. [Abstract] [Full Text] [PDF]
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 J. W Olin, C. Fonseca, M. B. Childs, M. R Piedmonte, N. R Hertzer, and J. R Young The natural history of asymptomatic moderate internal carotid artery stenosis by duplex ultrasound Vascular Medicine, May 1, 1998; 3(2): 101 - 108. [Abstract] [PDF]
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R. Vanninen, M. Aikia, M. Kononen, K. Partanen, H. Tulla, P. Hartikainen, J. Partanen, H. Manninen, P. Enberg, and M. Hippelainen Subclinical Cerebral Complications After Coronary Artery Bypass Grafting: Prospective Analysis With Magnetic Resonance Imaging, Quantitative Electroencephalography, and Neuropsychological Assessment Arch Neurol, May 1, 1998; 55(5): 618 - 627. [Abstract] [Full Text] [PDF]
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 D. E. Wennberg, F. L. Lucas, J. D. Birkmeyer, C. E. Bredenberg, and E. S. Fisher Variation in Carotid Endarterectomy Mortality in the Medicare Population: Trial Hospitals, Volume, and Patient Characteristics JAMA, April 22, 1998; 279(16): 1278 - 1281. [Abstract] [Full Text] [PDF]
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R. D. Cebul, R. J. Snow, R. Pine, N. R. Hertzer, and D. G. Norris Indications, Outcomes, and Provider Volumes for Carotid Endarterectomy JAMA, April 22, 1998; 279(16): 1282 - 1287. [Abstract] [Full Text] [PDF]
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A. Mathur, G. S. Roubin, S. S. Iyer, C. Piamsonboon, M. W. Liu, C. R. Gomez, J. S. Yadav, H. D. Chastain, L. M. Fox, L. S. Dean, et al. Predictors of Stroke Complicating Carotid Artery Stenting Circulation, April 7, 1998; 97(13): 1239 - 1245. [Abstract] [Full Text] [PDF]
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J. Biller, W. M. Feinberg, J. E. Castaldo, A. D. Whittemore, R. E. Harbaugh, R. J. Dempsey, L. R. Caplan, T. F. Kresowik, D. B. Matchar, J. F. Toole, et al. Guidelines for Carotid Endarterectomy : A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association Circulation, February 10, 1998; 97(5): 501 - 509. [Full Text] [PDF]
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J. Biller, W. M. Feinberg, J. E. Castaldo, A. D. Whittemore, R. E. Harbaugh, R. J. Dempsey, L. R. Caplan, T. F. Kresowik, D. B. Matchar, J. F. Toole, et al. Guidelines for Carotid Endarterectomy : A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association Stroke, February 1, 1998; 29(2): 554 - 562. [Full Text] [PDF]
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 C. Specker, A. Perniok, U. Brauckmann, M. Siebler, and M. Schneider Review : Detection of cerebral microemboli in APS-- Introducing a novel investigation method and implications of analogies with carotid artery disease Lupus, January 1, 1998; 7(2_suppl): S75 - S80. [Abstract] [PDF]
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