Large landmark trials (NASCET, ECST, ACAS and ACST)1-4 firmly established the indications for carotid endarterectomy (CEA) in patients with symptomatic stenosis of > 50%, and asymptomatic stenosis of > 60%. Single- and multicentre randomised trials (CAVATAS, Kentucky study, Leicester study, Wallstent study, SAPPHIRE), and two recently published multicentre trials (SPACE and EVA-3S), have directly compared CEA to carotid artery stenting (CAS), and have generated widespread debate with conflicting results. At this juncture, acknowledgement of the hard work performed by these investigators, critical analysis of trial methodology, and reassessment of the utility of CAS is appropriate.
CAVATAS randomised 504 patients, 88% of ...
TAVI dysfunction, coronary sinus narrowing, carotid interventions through the snuffbox, and more
CT image showing a case of valve thrombosis after ViV TAVI
February 20, 2020