Long-term follow-up study of endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis trial - Archive ouverte HAL Access content directly
Journal Articles Stroke Year : 2014

Long-term follow-up study of endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis trial

, , , , , , , , , , , , , , , , , , , , , , , , , , , (1) ,
1
J. L. Mas
  • Function : Author
C. Arquizan
D. Calvet
  • Function : Author
A. Viguier
  • Function : Author
Jean-François Albucher
  • Function : Author
P. Piquet
  • Function : Author
P. Garnier
  • Function : Author
F. Viader
  • Function : Author
M. Giroud
  • Function : Author
H. Hosseini
  • Function : Author
G. Hinzelin
  • Function : Author
P. Favrole
  • Function : Author
H. Henon
  • Function : Author
J. P. Neau
  • Function : Author
X. Ducrocq
  • Function : Author
R. Padovani
  • Function : Author
L. Milandre
  • Function : Author
F. Rouanet
  • Function : Author
V. Wolff
  • Function : Author
D. Saudeau
  • Function : Author
M. H. Mahagne
  • Function : Author
D. Sablot
  • Function : Author
P. Amarenco
  • Function : Author
V. Larrue
  • Function : Author
B. Beyssen
  • Function : Author
D. Leys
  • Function : Author
T. Moulin
  • Function : Author
G. Chatellier
  • Function : Author

Abstract

Background and Purpose-We aimed at comparing the long-term benefit-risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis. Methods-Long-term follow-up study of patients included in Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3S), a randomized, controlled trial of carotid stenting versus endarterectomy in 527 patients with recently symptomatic severe carotid stenosis, conducted in 30 centers in France. The main end point was a composite of any ipsilateral stroke after randomization or any procedural stroke or death. Results-During a median follow-up of 7.1 years (interquartile range, 5.1-8.8 years; maximum 12.4 years), the primary end point occurred in 30 patients in the stenting group compared with 18 patients in the endarterectomy group. Cumulative probabilities of this outcome were 11.0% (95% confidence interval, 7.9-15.2) versus 6.3% (4.0-9.8) in the endarterectomy group at the 5-year follow-up (hazard ratio, 1.85; 1.00-3.40; P=0.04) and 11.5% (8.2-15.9) versus 7.6% (4.9-11.8; hazard ratio, 1.70; 0.95-3.06; P=0.07) at the 10-year follow-up. No difference was observed between treatment groups in the rates of ipsilateral stroke beyond the procedural period, severe carotid restenosis (>= 70%) or occlusion, death, myocardial infarction, and revascularization procedures. Conclusions-The long-term benefit-risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis favored endarterectomy, a difference driven by a lower risk of procedural stroke after endarterectomy. Both techniques were associated with low and similar long-term risks of recurrent ipsilateral stroke beyond the procedural period.

Dates and versions

hal-02045126 , version 1 (21-02-2019)

Identifiers

Cite

J. L. Mas, C. Arquizan, D. Calvet, A. Viguier, Jean-François Albucher, et al.. Long-term follow-up study of endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis trial. Stroke, 2014, 45 (9), pp.2750-6. ⟨10.1161/STROKEAHA.114.005671⟩. ⟨hal-02045126⟩
20 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More