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20 Cards in this Set
- Front
- Back
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Two arms of ACAS
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ASA 325 qd vs. CEA + ASA 325 qd
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ACAS patient population
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1662 pts, ages 40-79, 60-99% stenosis
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ACAS primary endpoint
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Ipsilateral stroke, or any perioperative stroke or death
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ACAS mean patient follow-up
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2.7 years
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ACAS main outcome
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Aggregate 5-year risk 11% for no surgery, 5.1% for surgery (aggregate risk reduction 53%)
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Secondary results of ACAS
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Risk reduction greater for men (66% vs 17%); more perioperative complications for women (3.6% vs 1.7%)
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NNT for stroke prevention with CEA per ACAS
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17
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Per ACAS, relationship between surgery benefit and degree of stenosis
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No relationship between degree of stenosis and risk reduction
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Per ACAS, a perioperative complication rate of less than ___ is needed to maintain a survival benefit for CEA
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<3%
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Delayed benefit demonstrated by ACAS
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Net benefit delayed for 2 years among asymptomatic patients due to perioperative morbidity
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NASCET patient population
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1212 pts, TIA or nondisabling stroke within 120, 70-99% stenosis
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NASCET primary endpoint
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Non-fatal and fatal stroke or death
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NASCET mean patient follow-up
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18 months
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NASCET results: any stroke or death
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Lower with CEA (15.8% vs 32.3%) at two years
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NASCET results: ipsilateral stroke
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Lower with CEA (26% vs 9%) at two years
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NASCET results: major or fatal ipsilateral stroke
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Lower with CEA (2.5% vs 13.1%) at two years
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NASCET results: major stroke or death
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Lower with CEA (8% vs 19.1%) at two years
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NASCET subanalysis: 50-69% symptomatic stenosis
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Lower stroke rate with CEA (15.7 vs 22.2) at five years
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NASCET subanalysis: <50% symptomatic stenosis
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No benefit
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NASCET RRR for ipsilateral stroke
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65%
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