Carotid artery stenting versus carotid endarterectomy - A prospective randomised controlled single-centre trial with long-term follow-up (BACASS)

Abstract

Background and objective: Safety and effectiveness of carotid artery stenting (CAS) was compared with carotid endarterectomy (CEA) in a single-centre prospective randomised controlled trial in symptomatic high-grade stenosis of the ICA. Material and methods: Twenty patients with symptomatic ICA stenosis a ≥70% were prospectively randomised to either CAS or CEA. Primary outcome measures were periprocedural stroke, death or myocardial infarction. Secondary outcome measures were peri-interventional transient TIA, bleeding complications, cranial nerve paralysis, length of stay and ICA patency as well as stroke or death during long-term follow-up. Results: CAS patients had no peri-interventional complications. In the CEA group 1/10 had an ipsilateral non-disabling stroke after 16 days. During long-term follow-up (48.1 ± 21.3 months with CAS and 43.5 ± 19.5 months with CEA) neither strokes nor myocardial infarctions occurred in both groups. Length of stay was 3.5 ± 1.8 days for CAS versus 7.3 ± 3.3 days for CEA patients. CEA and CAS groups did not differ in other secondary outcome measures. Conclusion: CAS and CEA seem to be comparably safe in our setting. More importantly, data useful for a systematic meta-analysis are provided, which include long-term results.