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(Stroke. 2006;37:344.)
© 2006 American Heart Association, Inc.

Letters to the Editor

Carotid Endarterectomy Versus Stenting: An International Perspective

Department of Neurology, Ruprecht-Karls-University Heidelberg, Germany

Martin M. Brown, MD

University College London, ICSS Central Office, The National Hospital for Neurology and Neurosurgery, London, UK

Jean-Louis Mas, MD

Service de Neurologie, Unité Neuro-Vasculaire, Hôpital Sainte-Anne, Paris Cedex, France

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

With interest we read the comment of Hobson et al entitled "Carotid Artery Stenting and the Recruitment Challenges in a clinical trial."¹

Although we completely share the concerns of the authors regarding slow recruitment into the CREST Trial, constantly growing use of carotid stenting in symptomatic patients outside of protocols, and the lack of evidence in this area, we cannot agree with the perception that it is mostly up to CREST to solve the problems.

The authors mention shortly that larger clinical trials "are currently underway in North America and Europe." With reference 10 they cite the CAVATAS trial that finished recruitment long ago. They state that "recruitment into these trials will also be slow and the data may not be available for the next 2 to 3 years."

As the principal investigators of 3 European Trials, we would like to update the organizers of CREST and the readers of Stroke in the field of what’s going on in the randomized symptomatic carotid endarterectomy versus stenting trials outside of North America.

The early results of CAVATAS were published 3 years ago and the results of long-term follow-up were presented at this year’s European Stroke Conference and will be submitted for publication soon.

The next on-going trial is the International Carotid Stenting Study (ICSS), the follow-up to the CAVATAS trial. This trial includes North American centers in Canada as well as several European countries and Australia, and its study protocol has been recently published.² Almost 600 patients are . . . [Full Text of this Article]

Robert W. Hobson, II

University of Medicine and Dentistry, New Jersey Medical School, Newark, NJ

Thomas G. Brott

Mayo Clinic Jacksonville, FL

Gary S. Roubin

Lenox Hill Hospital New York, NY

Frank L. Silver

Toronto Western Hospital Toronto, ON, Canada

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				R. F. Bonvini, M. Righini, M. Hamon, J. W. Riddell, A. O. Maree, K. A. Rosenfield, J.-L. Mas, G. Chatellier, and the EVA-3S Investigators Endarterectomy versus Stenting for Carotid Stenosis N. Engl. J. Med., January 18, 2007; 356(3): 305 - 307. [Full Text] [PDF]