Published online before print December 4, 2003, doi: 10.1161/01.STR.0000106913.33940.DD
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(Stroke. 2004;35:e18.)
© 2004 American Heart Association, Inc.
Research Report |
Carotid Angioplasty and Stenting With and Without Cerebral Protection
Clinical Alert From the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3S) Trial
EVA-3S InvestigatorsCorrespondence to Prof Jean-Louis Mas, Dept of Neurology, Hôpital Sainte-Anne, 1 rue Cabanis, 75674 Paris Cedex 14, France. E-mail mas{at}chsa.broca.inserm.fr
Background and Purpose— Whether cerebral protection during carotid angioplasty and stenting (CAS) is associated with a lower risk of periprocedural stroke or death remains to be established. We report on 80 patients randomized in the CAS arm of the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis trial comparing CAS (with or without cerebral protection) with carotid surgery in patients with recently symptomatic, severe carotid stenosis.
Summary of Report— The Safety Committee recommended stopping unprotected CAS, because the 30-day rate of stroke was 3.9 (0.9 to 16.7) times higher than that of CAS with cerebral protection (4/15 versus 5/58).
Conclusion— Although this result was not based on a randomized comparison of unprotected versus protected CAS, it suggests that the use of cerebral protection devices during CAS reduces periprocedural strokes.
Key Words: angioplasty • carotid endarterectomy • carotid stenosis • cerebral ischemia, transient • stents • stroke
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