| Restenosis is more frequent after carotid stenting than after endarterectomy: the EVA-3S study. | |
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MedLine Citation:
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PMID: 21311065 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Carotid angioplasty and stenting (CAS) may be more often associated with residual or recurrent stenosis than carotid endarterectomy (CEA). We compared the rates of restenosis in patients treated with CAS or CEA in the EVA-3S trial. METHODS: Five hundred seven patients (242 treated by CAS and 265 by CEA) had carotid ultrasound follow-up (mean carotid ultrasound follow-up, 2.1 years) according to a predefined protocol. Carotid restenosis of 50% to 69% was diagnosed on planimetry, whereas carotid restenosis of ≥70% or occlusion was diagnosed using either planimetry or velocity criteria. RESULTS: The rate of carotid restenosis of ≥50% or occlusion was significantly higher after CAS (12.5%) than after CEA (5.0%; time ratio, 0.16; 95% CI, 0.03-0.76; P=0.02). The rates of severe restenosis of ≥70% or occlusion were low and did not differ significantly between the 2 groups (3-year rates are 3.3% in the CAS group and 2.8% in the CEA group). Age at baseline was the only vascular risk factor significantly associated with carotid restenosis. Our study could not detect any effect of carotid restenosis on ipsilateral stroke. CONCLUSIONS: The short-term rate of carotid restenosis of ≥50% or occlusion is ≈2.5-times more common after CAS than after CEA, a difference accounted for by an excess risk in moderate restenosis. More data with longer follow-up are needed to assess the rates of late severe restenosis and to determine the relation between restenosis and recurrent stroke over time. |
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Authors:
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Caroline Arquizan; Ludovic Trinquart; Pierre-Jean Touboul; Anne Long; Séverine Feasson; Béatrice Terriat; Marie-Pierre Gobin-Metteil; Brigitte Guidolin; Serge Cohen; Jean-Louis Mas; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2011-02-10 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 42 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-29 Completed Date: 2011-05-31 Revised Date: 2011-10-05 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1015-20 Citation Subset: IM |
Affiliation:
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Service de Neurologie, Hôpital Gui de Chauliac, Université Montpellier, INSERM UMR894, Montpellier, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty / instrumentation*, methods, trends* Carotid Stenosis / diagnosis, surgery*, ultrasonography Endarterectomy, Carotid / methods, trends Female Graft Occlusion, Vascular / diagnosis, surgery, ultrasonography Humans Male Middle Aged Outcome Assessment (Health Care) / methods, trends Recurrence / prevention & control Risk Factors Single-Blind Method Stents / adverse effects Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Praxis (Bern 1994). 2011 Sep 7;100(18):1127-8
[PMID:
21932203
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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