Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery : results from 4 randomized controlled trials

Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated...
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Autor*in:	Rantner, Barbara [verfasserIn] Ringleb, Peter A. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	28 Apr 2017

Anmerkung:	Originally published: 28 Apr 2017 Gesehen am 31.07.2018
Umfang:	8

Übergeordnetes Werk:	Enthalten in: Stroke - New York, NY : Association, 1970, 48(2017), 6, Seite 1580-1587
Übergeordnetes Werk:	volume:48 ; year:2017 ; number:6 ; pages:1580-1587 ; extent:8

Links:	Volltext Volltext

DOI / URN:	10.1161/STROKEAHA.116.016233

Katalog-ID:	1578088941

Internformat


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245	1	0	\|a Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery \|b results from 4 randomized controlled trials \|c Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich
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520			\|a Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke.
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Indexfelder

author_variant	b r br p a r pa par
matchkey_str	article:15244628:2017----::aledreetmcrislwrrcdrlikhnalsetniptetwtsmtmtct
oclc_num	1341015753
hierarchy_sort_str	28 Apr 2017
publishDate	2017
allfields	10.1161/STROKEAHA.116.016233 doi (DE-627)1578088941 (DE-576)508088941 (DE-599)BSZ508088941 (OCoLC)1341015753 DE-627 ger DE-627 rda eng Rantner, Barbara verfasserin (DE-588)1163616141 (DE-627)1027930115 (DE-576)508087473 aut Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich 28 Apr 2017 8 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Originally published: 28 Apr 2017 Gesehen am 31.07.2018 Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Ringleb, Peter A. verfasserin (DE-588)1032676175 (DE-627)73863364X (DE-576)172917743 aut Enthalten in Stroke New York, NY : Association, 1970 48(2017), 6, Seite 1580-1587 Online-Ressource (DE-627)266879985 (DE-600)1467823-8 (DE-576)075145731 1524-4628 nnns volume:48 year:2017 number:6 pages:1580-1587 extent:8 http://dx.doi.org/10.1161/STROKEAHA.116.016233 Verlag Resolving-System kostenfrei Volltext http://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.116.016233 Verlag kostenfrei Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 48 2017 6 1580-1587 8 2013 01 DE-16-250 301978090X 00 --%%-- --%%-- --%%-- --%%-- l01 31-07-18 2403 01 DE-LFER 3020653800 00 --%%-- --%%-- n --%%-- l01 13-08-18 2403 01 DE-LFER http://dx.doi.org/10.1161/STROKEAHA.116.016233 2013 01 DE-16-250 00 s hd2017 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_19 2013 01 DE-16-250 03 s s_8 2013 01 DE-16-250 04 p (DE-627)1450182887 Ringleb, Peter A. 2013 01 DE-16-250 04 k (DE-627)1416741267 Neurologische Universitätsklinik 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_4
spelling	10.1161/STROKEAHA.116.016233 doi (DE-627)1578088941 (DE-576)508088941 (DE-599)BSZ508088941 (OCoLC)1341015753 DE-627 ger DE-627 rda eng Rantner, Barbara verfasserin (DE-588)1163616141 (DE-627)1027930115 (DE-576)508087473 aut Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich 28 Apr 2017 8 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Originally published: 28 Apr 2017 Gesehen am 31.07.2018 Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Ringleb, Peter A. verfasserin (DE-588)1032676175 (DE-627)73863364X (DE-576)172917743 aut Enthalten in Stroke New York, NY : Association, 1970 48(2017), 6, Seite 1580-1587 Online-Ressource (DE-627)266879985 (DE-600)1467823-8 (DE-576)075145731 1524-4628 nnns volume:48 year:2017 number:6 pages:1580-1587 extent:8 http://dx.doi.org/10.1161/STROKEAHA.116.016233 Verlag Resolving-System kostenfrei Volltext http://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.116.016233 Verlag kostenfrei Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 48 2017 6 1580-1587 8 2013 01 DE-16-250 301978090X 00 --%%-- --%%-- --%%-- --%%-- l01 31-07-18 2403 01 DE-LFER 3020653800 00 --%%-- --%%-- n --%%-- l01 13-08-18 2403 01 DE-LFER http://dx.doi.org/10.1161/STROKEAHA.116.016233 2013 01 DE-16-250 00 s hd2017 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_19 2013 01 DE-16-250 03 s s_8 2013 01 DE-16-250 04 p (DE-627)1450182887 Ringleb, Peter A. 2013 01 DE-16-250 04 k (DE-627)1416741267 Neurologische Universitätsklinik 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_4
allfields_unstemmed	10.1161/STROKEAHA.116.016233 doi (DE-627)1578088941 (DE-576)508088941 (DE-599)BSZ508088941 (OCoLC)1341015753 DE-627 ger DE-627 rda eng Rantner, Barbara verfasserin (DE-588)1163616141 (DE-627)1027930115 (DE-576)508087473 aut Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich 28 Apr 2017 8 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Originally published: 28 Apr 2017 Gesehen am 31.07.2018 Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Ringleb, Peter A. verfasserin (DE-588)1032676175 (DE-627)73863364X (DE-576)172917743 aut Enthalten in Stroke New York, NY : Association, 1970 48(2017), 6, Seite 1580-1587 Online-Ressource (DE-627)266879985 (DE-600)1467823-8 (DE-576)075145731 1524-4628 nnns volume:48 year:2017 number:6 pages:1580-1587 extent:8 http://dx.doi.org/10.1161/STROKEAHA.116.016233 Verlag Resolving-System kostenfrei Volltext http://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.116.016233 Verlag kostenfrei Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 48 2017 6 1580-1587 8 2013 01 DE-16-250 301978090X 00 --%%-- --%%-- --%%-- --%%-- l01 31-07-18 2403 01 DE-LFER 3020653800 00 --%%-- --%%-- n --%%-- l01 13-08-18 2403 01 DE-LFER http://dx.doi.org/10.1161/STROKEAHA.116.016233 2013 01 DE-16-250 00 s hd2017 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_19 2013 01 DE-16-250 03 s s_8 2013 01 DE-16-250 04 p (DE-627)1450182887 Ringleb, Peter A. 2013 01 DE-16-250 04 k (DE-627)1416741267 Neurologische Universitätsklinik 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_4
allfieldsGer	10.1161/STROKEAHA.116.016233 doi (DE-627)1578088941 (DE-576)508088941 (DE-599)BSZ508088941 (OCoLC)1341015753 DE-627 ger DE-627 rda eng Rantner, Barbara verfasserin (DE-588)1163616141 (DE-627)1027930115 (DE-576)508087473 aut Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich 28 Apr 2017 8 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Originally published: 28 Apr 2017 Gesehen am 31.07.2018 Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Ringleb, Peter A. verfasserin (DE-588)1032676175 (DE-627)73863364X (DE-576)172917743 aut Enthalten in Stroke New York, NY : Association, 1970 48(2017), 6, Seite 1580-1587 Online-Ressource (DE-627)266879985 (DE-600)1467823-8 (DE-576)075145731 1524-4628 nnns volume:48 year:2017 number:6 pages:1580-1587 extent:8 http://dx.doi.org/10.1161/STROKEAHA.116.016233 Verlag Resolving-System kostenfrei Volltext http://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.116.016233 Verlag kostenfrei Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 48 2017 6 1580-1587 8 2013 01 DE-16-250 301978090X 00 --%%-- --%%-- --%%-- --%%-- l01 31-07-18 2403 01 DE-LFER 3020653800 00 --%%-- --%%-- n --%%-- l01 13-08-18 2403 01 DE-LFER http://dx.doi.org/10.1161/STROKEAHA.116.016233 2013 01 DE-16-250 00 s hd2017 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_19 2013 01 DE-16-250 03 s s_8 2013 01 DE-16-250 04 p (DE-627)1450182887 Ringleb, Peter A. 2013 01 DE-16-250 04 k (DE-627)1416741267 Neurologische Universitätsklinik 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_4
allfieldsSound	10.1161/STROKEAHA.116.016233 doi (DE-627)1578088941 (DE-576)508088941 (DE-599)BSZ508088941 (OCoLC)1341015753 DE-627 ger DE-627 rda eng Rantner, Barbara verfasserin (DE-588)1163616141 (DE-627)1027930115 (DE-576)508087473 aut Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich 28 Apr 2017 8 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Originally published: 28 Apr 2017 Gesehen am 31.07.2018 Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Ringleb, Peter A. verfasserin (DE-588)1032676175 (DE-627)73863364X (DE-576)172917743 aut Enthalten in Stroke New York, NY : Association, 1970 48(2017), 6, Seite 1580-1587 Online-Ressource (DE-627)266879985 (DE-600)1467823-8 (DE-576)075145731 1524-4628 nnns volume:48 year:2017 number:6 pages:1580-1587 extent:8 http://dx.doi.org/10.1161/STROKEAHA.116.016233 Verlag Resolving-System kostenfrei Volltext http://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.116.016233 Verlag kostenfrei Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 48 2017 6 1580-1587 8 2013 01 DE-16-250 301978090X 00 --%%-- --%%-- --%%-- --%%-- l01 31-07-18 2403 01 DE-LFER 3020653800 00 --%%-- --%%-- n --%%-- l01 13-08-18 2403 01 DE-LFER http://dx.doi.org/10.1161/STROKEAHA.116.016233 2013 01 DE-16-250 00 s hd2017 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_19 2013 01 DE-16-250 03 s s_8 2013 01 DE-16-250 04 p (DE-627)1450182887 Ringleb, Peter A. 2013 01 DE-16-250 04 k (DE-627)1416741267 Neurologische Universitätsklinik 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_4
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fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a2200265 4500</leader><controlfield tag="001">1578088941</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20220814203734.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">180731s2017 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1161/STROKEAHA.116.016233</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)1578088941</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-576)508088941</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)BSZ508088941</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(OCoLC)1341015753</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Rantner, Barbara</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(DE-588)1163616141</subfield><subfield code="0">(DE-627)1027930115</subfield><subfield code="0">(DE-576)508087473</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery</subfield><subfield code="b">results from 4 randomized controlled trials</subfield><subfield code="c">Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">28 Apr 2017</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">8</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">Originally published: 28 Apr 2017</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">Gesehen am 31.07.2018</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. 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title	Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials
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title_full	Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. Brott, Gustav Fraedrich
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title_sub	results from 4 randomized controlled trials
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title_sort	early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid arteryresults from 4 randomized controlled trials
title_auth	Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery results from 4 randomized controlled trials
abstract	Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Originally published: 28 Apr 2017 Gesehen am 31.07.2018
abstractGer	Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Originally published: 28 Apr 2017 Gesehen am 31.07.2018
abstract_unstemmed	Background and Purpose: Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. Methods: We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists’ Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Results: Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). Conclusions: In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. Originally published: 28 Apr 2017 Gesehen am 31.07.2018
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container_issue	6
title_short	Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery
url	http://dx.doi.org/10.1161/STROKEAHA.116.016233 http://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.116.016233
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author2	Ringleb, Peter A.
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doi_str	10.1161/STROKEAHA.116.016233
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up_date	2024-07-04T09:48:52.916Z
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Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M. Brown, Jean-Louis Mas, Thomas G. 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Early endarterectomy carries a lower procedural risk than early stenting in patients with symptomatic stenosis of the internal carotid artery : results from 4 randomized controlled trials

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