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Titolo:
ENDARTERECTOMY FOR ASYMPTOMATIC CAROTID-ARTERY STENOSIS
Autore:
WALKER MD; MARLER JR; GOLDSTEIN M; GRADY PA; TOOLE JF; BAKER WH; CASTALDO JE; CHAMBLESS LE; MOORE WS; ROBERTSON JT; YOUNG B; HOWARD VJ; PURVIS S; VERNON DD; NEEDHAM K; BECK P; DOZIER M; LEFKOWITZ DS; HOWARD G; CROUSE JR; HERRINGTON DM; FURBERG CD; ESSICK K; HICKS RM; NELSON JJ; BALL W; BLAND E; CONDON S; ELLIOTT T; GRIZZLE JE; HAYES D; HENLEY S; JOHNSON J; LOCKLEAR J; MISCH MS; PATON CC; SCHWARTZ S; WALKER C; WILLIAMS OD; EASTON JD; GOLDSTONE J; HALLENBECK JM; HOFF JT; KARP HR; KRONMAL RA; BROTT TG; TOMSICK TA; BRODERICK J; SAUERBECK L; BLUM C; DYKEN M; BRUST JCM; DICK AR; GOTSHALL RA; HEYMAN A; SWANSON PD; ADAMS HP; DEMPSEY R; ERNST CB; ROTHROCK J; COHEN SN; NICHOLAS G; LONGENECKER J; BARBOUR P; BERGER A; CELANI VJ; ECKERT N; GOODREAU J; HUTCHINSON J; JENNY D; LIN ZS; MCDONALD K; PISTONE W; RAEGRANT AD; REDENBAUGH J; REX J; WOHLBERG CJ; KARANJIA P; SWANSON M; LOBNER S; KOLTS RL; KUEHNER ME; HINER BC; MADDEN KP; CARLSON RD; DAVIS JS; GALLANT T; WARNER JJ; FAUST A; FRYZA N; HASENAUER J; REGNER M; RONKIN L; SCHAEFER S; STRACK D; TURNER LC; WALGENBACH A; GRAVES J; MICHALSKI S; SCHUETTE L; MOHR JP; TATEMICHI TK; MARSHALL R; MAST H; RAMOS O; CORRELL J; LIBMAN R; PETTY G; CABRERE A; OROPEZA L; GONZALEZ T; PETTIGREW C; SADLER R; ENDEAN E; SHERROW J; HAUER M; LEE C; NORTON J; MCQUILLEN M; MATTINGLY S; DEKOSKY S; MASSEY A; SIMARD D; TURCOTTE JF; BENGUIGUI C; COTE J; BOUCHARD JM; ROBERGE C; BRUNET D; BEDARD F; LANGELIER R; LAJEUNESSE M; BIGAOUETTE JM; PARENT J; LYDEN P; HYE R; LEWIS S; CALI G; BABCOCK T; TAFTALVAREZ B; BRODY M; ZWEIFLER R; SEDWITZ M; STABILE B; FREISCHLAG JA; WOLF YG; SIVO J; FORSYTHE J; ADAME M; GUPTA S; BURKE K; GREISLER HP; LITTOOY FN; KELLY MA; PULSINELLI W; CAMPBELL JA; CROCKARELL J; WATRIDGE C; ACKER J; ERKULWATER S; JACEWICZ M; WALKER G; OSULLIVAN P; SAUER C; VASU K; GAINES K; BAKHITIAN B; BERTORINI TE; BENNETT S; THOMAS T; STAHL N; TAYLOR C; GIAMPAPA MA; CONNELL J; RILEY J; BRADLEY A; DAVIS J; NEWMAN K; MANNING R; MCCREA M; HACHINSKI V; FERGUSON G; MAYER C; BARNETT JM; PEERLESS SJ; BUCHAN AM; REICHMAN H; KERTESZ A; LOWNIE S; WHITE C; FOX A; RANKIN R; SPENCE JD; BARR HWK; PADDOCKELIASZIW L; ASSIS LJP; PEXMAN JHW; DICICCO M; TATE B; JAMES C; RAKER E; COATSWORTH J; HARRIS S; BEEBE H; BIRCHFIELD R; BUTLERLEVY K; CRANE R; FRYER D; MACLEAN J; PATTERSON L; QUIGLEY T; RAVITS J; TAYLOR L; PULLEN S; BOSWELL S; KENNY K; BROTT T; TOMSICK T; ROEDERSHEIMER LR; FOWL R; TEW J; KEMPCZINSKI R; REED R; WELLING R; SCHOMAKER B; LEFKOWITZ D; MCWHORTER JM; BRANCH CL; SATTERFIELD J; CORDELL R; DEAN R; PLONK G; HARPOLD G; WALKER F; NUNN C; MYERS L; TEGELER C; HARDIN S; MEADS D; LOFTUS CM; VINING LA; BENDIXEN BH; BILLER J; CORSON JD; DAVIS PH; GODERSKY JC; GORDON DL; JACOBY MR; KAPPELLE LJ; KRESOWIK TF; MARSH EE; LOVE BB; SHAMMA AR; GRIMSMAN KJ; KARBOSKI DM; MILLER EV; JOHNSON C; JONES C; STONE B; MAGUIRE MP; EARLEY C; KAPLAN P; CAVALUZZI J; WATERS G; CHACHICH B; AUER A; LOGAN W; WILCOX M; GREEN B; HURLEY J; PENNELL R; WOODS J; LEVINE R; NEPUTE J; THOMASSON J; BLACKBURN C; FOLDES M; KLEMP K; NAPPIER B; RUTHERFORD K; SCHROER S; HOGAN J; THORPE L; FEINBERG WM; HUNTER GC; BRUCK DC; BERNHARD VM; MCINTYRE KE; CARTER LP; LABADIE EL; JOHNSON DS; MOSCHONAS CG; HAMILTON RH; FORRER SC; SEEGER JF; CARMODY RF; VOLD BK; CARLSON RL; LAGUNA JE; KRIKAWA JP; DEVINE JJ; CASTRILLO AM; KISTLER SL; LEDBETTER B; DORR K; SMITH RR; HAERER AF; BROWN RL; RUSSELL W; RIGDON E; RHODES R; SMITH E; GRAEBER M; DOORENBOS D; SUBRAMONY SH; ATNIP RG; BRENNAN RW; FRIEDMAN D; NEUMYER MM; THIELE BL; SMITH F; BARR JD; DUCKROW RB; JANESKY C; MEILSTRUP JW; MCNAMARA KP; RODICHOK LD; STEWART L; SULLIVAN M; WENGROVITZ M; CLAGETT GP; UNWIN H; BRYAN W; MATKINS C; PATTERSON C; ALWAY C; BOYD P; INMAN M; ALBISTON C; SCOGGINS E; SWILLING J; WALDEN KG; AHN SS; AMOS EC; BAKER JD; DOBKIN BH; DONAYRE CE; GELABERT HA; JORDAN SE; MACHLEDER HI; QUINONESBALDRICH WJ; SAVER JL; ELSADEN SM; HOLGATE RC; JABOUR BA; JACOBS JB; ABRAHAM TM; VESCERA CL; VONRAJCS JA; CARTER VL; CARTER DT; DIXGOSS DE; HERNANDEZ EC; COULL B; LOBOA L; MONETA G; PORTER J; YEAGER R; WHITTAKER L; BRASS LM; GUSBERG RJ; LOVEJOY AM; FAYAD PB; SUMPIO B; MEIER GH; CHANG VM; MARZITELLI K; CHYATTE D; HAMMERS L; LEPORE F; PAVALKIS FJ; MELE J; KISIEL D; BARNES RW; CHESSER MZ; ARCHER RL; THOMPSON BW; MACDONALD C; BARONE GW; EIDT JF; HARSHFIELD D; MCFARLAND D; NICKOLS JR; HOWARD C; NIX ML; OVERSTREET JK; TROILLETT R; TAYLOR J; LEE HM; AKINS P; HARBISON JW; PRIDGEON RM; FELTON WL; POSNER M; SOBEL M; CLIFTON G; CONWAY C; COCKRELL A; STRINGER W; WINGO J; NICHOLS B; SMOKER W; FISHER R; SPETZLER RF; FREY JL; ZABRAMSKI JM; HUNSLEY SL; JAHNKE H; PLENGE KL; HOLLAND R; TURNER R; STRAVA D; STUMPFF S; HODAK J; FLOM RA; DEAN BL; THOMPSON RA; HUGHES R; LEPLER B; BOWEN J; BENOIT C; HOLLIER L; OCHSNER J; STRUB R; LANG V; CAHANIN V; HOBSON RW; WEISBROT F; KAMIN S; BACK T; JAMIL Z; ROGERS C; LAINSON B; HART L; CAPLAN L; ODONNELL T; BARRON L; PESSIN M; DEWITT D; MACKEY W; BELKIN M; MCGLAUGHLIN R; HEGGERICK P; WELCH KMA; WILCZEWSKI J; ROBERTSON W; DALEY S; ELLIOT JP; REDDY DJ; SHEPHARD AD; SMITH RF; LEVINE S; RAMADAN N; TIETJEN G; MITSIAS P; GORMAN M; MCPHARLIN M; PATEL S; DEVESHWAR R; LEE N; KOKKINOS J; WEINSTEIN E; KUNKEL J; KRATOCHVIL A; JOHNSON E; STEEL S; NORRIS J; ROWED D; BOWYER B; GAWEL M; COOPER PW; BRODIE D; KIRKLAND JS; SCHECTER JA; FARRAR NW; CAPPS R; RHODES EL; ROGERS DM; GLASS JT; NAGUSZEWSKI R; NAGUSZEWSKI W; MADDOX B; DOLLISON B; MOULTON L; COLE P; KINSELLA P; ANSLEY A; BRITZ N; BIVINS DH; WILLIAMS EL;
Indirizzi:
WAKE FOREST UNIV,BOWMAN GRAY SCH MED,CTR STROKE,MED CTR BLVD WINSTON SALEM NC 27157 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,CTR STROKE WINSTON SALEM NC 27157 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT NEUROL WINSTON SALEM NC 27157
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 18, volume: 273, anno: 1995,
pagine: 1421 - 1428
SICI:
0098-7484(1995)273:18<1421:EFACS>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
NATURAL-HISTORY; CLINICAL-TRIALS; OCCLUSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
M.D. Walker et al., "ENDARTERECTOMY FOR ASYMPTOMATIC CAROTID-ARTERY STENOSIS", JAMA, the journal of the American Medical Association, 273(18), 1995, pp. 1421-1428

Abstract

Objective.-To determine whether the addition of carotid endarterectomy to aggressive medical management can reduce the incidence of cerebral infarction in patients with asymptomatic carotid artery stenosis. Design.-Prospective, randomized, multicenter trial. Setting.-Thirty-nineclinical sites across the United States and Canada. Patients.-BetweenDecember 1987 and December 1993, a total of 1662 patients with asymptomatic carotid artery stenosis of 60% or greater reduction in diameterwere randomized; follow-up data are available on 1659. At baseline, recognized risk factors for stroke were similar between the two treatment groups. Intervention.-Daily aspirin administration and medical riskfactor management for ail patients; carotid endarterectomy for patients randomized to receive surgery. Main Outcome Measures.-Initially, transient ischemic attack or cerebral infarction occurring in the distribution of the study artery and any transient ischemic attack, stroke, or death occurring in the perioperative period. In March 1993, the primary; outcome measures were changed to cerebral infarction occurring in the distribution of the study artery or any stroke or death occurring in the perioperative period. Results.-After a median follow-up of 2.7 years, with 4657 patient-years of observation, the aggregate risk over 5 years for ipsilateral stroke and any perioperative stroke or death was estimated to be 5.1% for surgical patients and 11.0% for patients treated medically (aggregate risk reduction of 53% [95% confidence interval, 22% to 72%]). Conclusion.-Patients with asymptomatic carotid artery stenosis of 60% or greater reduction in diameter and whose general health makes them good candidates for elective surgery will have areduced 5-year risk of ipsilaterat stroke if carotid endarterectomy performed with less than 3% perioperative morbidity and mortality is added to aggressive management of modifiable risk factors.

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Documento generato il 22/09/20 alle ore 10:29:53