Universität zu Köln

Luebke, T. and Brunkwall, J. (2018). Current carotid artery studies enable valid treatment decisions. Gefasschirurgie, 23 (5). S. 306 - 312. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1434-3932

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Abstract

In the most recent and most comprehensive meta-analyses comparing carotid endarterectomy (CEA) with carotid angioplasty and stenting (CAS), the results of 15 randomized controlled studies (RCT) are summarized. Concerning the short-term outcomes CAS was associated with a 61% increase in the risk of periprocedural 30-day mortality or stroke as compared with CEA. Furthermore, the trial sequential analysis (TSA) showed firm evidence of the advantage of CEA compared to CAS (at least a 20% relative risk reduction) for the endpoint periprocedural death or stroke. According to the metaregression analysis only a certain proportion of men had a statistically significant modifying effect on the endpoints 30-day mortality and stroke rates in the sense of a protective factor. With respect to the intermediate and long-term outcomes in meta-analyses CAS in comparison to CEA was associated with a 42% increase in the risk for the composite endpoint of periprocedural stroke or death and ipsilateral stroke in follow-up, a 33% increase in the relative risk for death or stroke and a 42% increase in the risk for any stroke in follow-up. For the long-term outcome and in particular for the combination endpoint of periprocedural death or stroke plus ipsilateral stroke in follow-up, TSA, however, showed insufficient data validity (with at least a 20% relative risk reduction) for a definite conclusion, so that a longer follow-up of the individual RCTs would be desirable for a clear assessment of the long-term results by inclusion of further results.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Luebke, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-175352
DOI:	10.1007/s00772-018-0422-8
Journal or Publication Title:	Gefasschirurgie
Volume:	23
Number:	5
Page Range:	S. 306 - 312
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1434-3932
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17535