Trial Outcomes & Findings for Carotid Angioplasty and Stenting Versus Endarterectomy in Asymptomatic Subjects Who Are at Standard Risk for Carotid Endarterectomy With Significant Extracranial Carotid Stenotic Disease (ACT I) (NCT NCT00106938)

NCT ID: NCT00106938

Last Updated: 2017-07-19

Results Overview

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

1663 participants

Primary outcome timeframe

0 to 365 days

Results posted on

2017-07-19

Participant Flow

Asymptomatic subjects with extracranial internal carotid stenosis which was ≥70% \& ≤99% by duplex ultrasound or ≥70% \& ≤99% by angiography (visual estimate) with or without involvement of the contiguous common carotid artery, who could undergo carotid artery stenting/carotid endarterectomy and all follow-ups, were recruited starting from April 2005

1453 patients were randomized to support the primary analysis; an additional 210 lead-in subjects were enrolled to allow investigators to gain experience with the study devices prior to randomizing subjects and were not part of the primary analysis.

Participant milestones

Participant milestones
Measure
CAS Group
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Overall Study
STARTED
1089
364
Overall Study
COMPLETED
913
293
Overall Study
NOT COMPLETED
176
71

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Carotid Angioplasty and Stenting Versus Endarterectomy in Asymptomatic Subjects Who Are at Standard Risk for Carotid Endarterectomy With Significant Extracranial Carotid Stenotic Disease (ACT I)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Total
n=1453 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
325 Participants
n=5 Participants
103 Participants
n=7 Participants
428 Participants
n=5 Participants
Age, Categorical
>=65 years
764 Participants
n=5 Participants
261 Participants
n=7 Participants
1025 Participants
n=5 Participants
Age, Continuous
67.7 years
STANDARD_DEVIATION 7.0 • n=5 Participants
67.9 years
STANDARD_DEVIATION 6.9 • n=7 Participants
67.7 years
STANDARD_DEVIATION 7.0 • n=5 Participants
Sex: Female, Male
Female
423 Participants
n=5 Participants
157 Participants
n=7 Participants
580 Participants
n=5 Participants
Sex: Female, Male
Male
666 Participants
n=5 Participants
207 Participants
n=7 Participants
873 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
985 participants
n=5 Participants
327 participants
n=7 Participants
1312 participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic or Latino
38 participants
n=5 Participants
12 participants
n=7 Participants
50 participants
n=5 Participants
Race/Ethnicity, Customized
Pacific Islander
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
45 participants
n=5 Participants
16 participants
n=7 Participants
61 participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaska
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
Asian
10 participants
n=5 Participants
4 participants
n=7 Participants
14 participants
n=5 Participants
Race/Ethnicity, Customized
Other
10 participants
n=5 Participants
4 participants
n=7 Participants
14 participants
n=5 Participants
Region of Enrollment
United States
1089 participants
n=5 Participants
364 participants
n=7 Participants
1453 participants
n=5 Participants

PRIMARY outcome

Timeframe: 0 to 365 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Composite of Death, Stroke (Ipsilateral or Contralateral; Major or Minor) and Myocardial Infarction (DSMI) Through 30 Days Post-procedure, Plus Ipsilateral Stroke 31 to 365 Days.
3.8 percentage of participants
3.4 percentage of participants

SECONDARY outcome

Timeframe: On day 0 after index procedure

Population: Device success is per device basis including the attempted devices only, including the attempted Carotid Artery Stenting (CAS) device only.

Defined as attainment of final residual diameter stenosis of \< 50% by Qualitative Comparative Analysis (QCA) (if QCA is not available, the visual estimate of diameter stenosis will be used) covering an area no longer than the original lesion with the study stent. (Routine post-dilatation of the stent may be included in this definition). Placement of an additional stent to treat a dissection or procedural complication as a bailout will not be considered a device success.

Outcome measures

Outcome measures
Measure
CAS Group
n=1049 devices
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Acute Device Success: Xact Carotid Stent
96.9 percentage of devices
Interval 95.6 to 97.8

SECONDARY outcome

Timeframe: On day 0 after index procedure

Population: Device success is per device basis including the attempted devices only, including the attempted Carotid Artery Stenting (CAS) device only.

Defined as successful deployment and retrieval of the filter in the absence of angiographic distal embolization.

Outcome measures

Outcome measures
Measure
CAS Group
n=1045 Devices
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Acute Device Success: Embolic Protection Device System
97.8 Percentage of devices
Interval 96.7 to 98.6

SECONDARY outcome

Timeframe: 0 to 30 days post procedure

Population: The analysis population is Procedure success is per subject basis including the attempted CAS (carotid artery stenting) procedure only. CEA group is not part of analysis population for procedure success.

Procedural success is defined as the attainment of target lesion final residual diameter stenosis of \< 50% by QCA (if QCA is not available, the visual estimate of diameter stenosis will be used) using any procedural method and freedom of Major Adverse Event at 30 days.

Outcome measures

Outcome measures
Measure
CAS Group
n=1025 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Procedural Success
95.6 percentage of participants

SECONDARY outcome

Timeframe: 0 to 30 Days Post-procedure

Population: Intent-to-Treat (ITT) population

A pre-specified composite Morbidity Measure (CMM) of cranial and peripheral nerve injury, vascular injury, non-cerebral bleeding, wound complications related to the neck incision or femoral puncture site, and other complications (anesthetic) at 30 days post-procedure.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Composite Morbidity Measure
Composite morbidity measure
31 participants
17 participants
Composite Morbidity Measure
Cranial nerve injury
1 participants
4 participants
Composite Morbidity Measure
Non-cerebral bleeding
21 participants
6 participants
Composite Morbidity Measure
Peripheral nerve injury
0.0 participants
0.0 participants
Composite Morbidity Measure
Vascular injury
8 participants
3 participants
Composite Morbidity Measure
CEA wound or access artery wound
3 participants
4 participants
Composite Morbidity Measure
Other complications
0 participants
0 participants

SECONDARY outcome

Timeframe: 0 to 180 days

Freedom from CI-TLR was defined as freedom from reintervention for ≥ 50% restenosis in recently symptomatic patients and ≥ 80% restenosis in asymptomatic patients.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Clinically Indicated Target Lesion Revascularization(CI-TLR)
99.8 percentage of partcipants
99.7 percentage of partcipants

SECONDARY outcome

Timeframe: 0 to 365 days

Freedom from CITLR was defined as freedom from reintervention for ≥ 50% restenosis in recently symptomatic patients and ≥ 80% restenosis in asymptomatic patients.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Clinically Indicated Target Lesion Revascularization
99.4 percentage of partcipants
97.4 percentage of partcipants

SECONDARY outcome

Timeframe: 0 to 730 days

Freedom from CITLR was defined as freedom from reintervention for ≥ 50% restenosis in recently symptomatic patients and ≥ 80% restenosis in asymptomatic patients.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Clinically Indicated Target Lesion Revascularization
98.7 percentage of partcipants
96.7 percentage of partcipants

SECONDARY outcome

Timeframe: 0 to 1095 days

Freedom from CITLR was defined as freedom from reintervention for ≥ 50% restenosis in recently symptomatic patients and ≥ 80% restenosis in asymptomatic patients.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Clinically Indicated Target Lesion Revascularization
98.4 percentage of partcipants
96.7 percentage of partcipants

SECONDARY outcome

Timeframe: 0 to 1460 days

Freedom from CITLR was defined as freedom from reintervention for ≥ 50% restenosis in recently symptomatic patients and ≥ 80% restenosis in asymptomatic patients.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Clinically Indicated Target Lesion Revascularization
98.4 percentage of partcipants
96.7 percentage of partcipants

SECONDARY outcome

Timeframe: 0 to 1825 days

Freedom from CITLR was defined as freedom from reintervention for ≥ 50% restenosis in recently symptomatic patients and ≥ 80% restenosis in asymptomatic patients.

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Clinically Indicated Target Lesion Revascularization
98.4 percentage of partcipants
96.7 percentage of partcipants

SECONDARY outcome

Timeframe: 31 to 365 days

Ipsilateral stroke was defined as stroke in the vascular distribution of the study carotid artery. If a subject experienced a bilateral stroke it was counted as an ipsilateral stroke for analysis purposes.

Outcome measures

Outcome measures
Measure
CAS Group
n=1049 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=333 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Ipsilateral Stroke
99.4 percentage of participants
99.1 percentage of participants

SECONDARY outcome

Timeframe: 31 to 730 days

Ipsilateral stroke was defined as stroke in the vascular distribution of the study carotid artery. If a subject experienced a bilateral stroke it was counted as an ipsilateral stroke for analysis purposes.

Outcome measures

Outcome measures
Measure
CAS Group
n=1049 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=333 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Ipsilateral Stroke
99.0 percentage of participants
98.7 percentage of participants

SECONDARY outcome

Timeframe: 31 to 1095 days

Ipsilateral stroke was defined as stroke in the vascular distribution of the study carotid artery. If a subject experienced a bilateral stroke it was counted as an ipsilateral stroke for analysis purposes.

Outcome measures

Outcome measures
Measure
CAS Group
n=1049 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=333 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Ipsilateral Stroke
98.4 percentage of participants
97.8 percentage of participants

SECONDARY outcome

Timeframe: 31 to 1460 days

Ipsilateral stroke was defined as stroke in the vascular distribution of the study carotid artery. If a subject experienced a bilateral stroke it was counted as an ipsilateral stroke for analysis purposes.

Outcome measures

Outcome measures
Measure
CAS Group
n=1049 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=333 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Ipsilateral Stroke
97.8 percentage of participants
97.3 percentage of participants

SECONDARY outcome

Timeframe: 31 to 1825 days

Ipsilateral stroke was defined as stroke in the vascular distribution of the study carotid artery. If a subject experienced a bilateral stroke it was counted as an ipsilateral stroke for analysis purposes.

Outcome measures

Outcome measures
Measure
CAS Group
n=1049 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=333 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Ipsilateral Stroke
97.8 percentage of participants
97.3 percentage of participants

SECONDARY outcome

Timeframe: 0 to 365 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Mortality
98.5 percentage of participants
99.1 percentage of participants

SECONDARY outcome

Timeframe: 0 to 730 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Mortality
96.2 percentage of participants
98.4 percentage of participants

SECONDARY outcome

Timeframe: 0 to 1095 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Mortality
94.3 percentage of partcipants
97.5 percentage of partcipants

SECONDARY outcome

Timeframe: 0 to 1460 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Mortality
91.5 percentage of participants
93.7 percentage of participants

SECONDARY outcome

Timeframe: 0 to 1825 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Mortality
87.1 percentage of participants
89.4 percentage of participants

SECONDARY outcome

Timeframe: 0 to 365 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From All Stroke
96.5 percentage of participants
97.7 percentage of participants

SECONDARY outcome

Timeframe: 0 to 730 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From All Stroke
95.8 percentage of participants
96.2 percentage of participants

SECONDARY outcome

Timeframe: 0 to 1095 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From All Stroke
94.5 percentage of participants
95.3 percentage of participants

SECONDARY outcome

Timeframe: 0 to 1460 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From All Stroke
93.8 percentage of participants
94.7 percentage of participants

SECONDARY outcome

Timeframe: 0 to 1825 days

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From All Stroke
93.1 percentage of participants
94.7 percentage of participants

SECONDARY outcome

Timeframe: ≤ 30 Days Post Index Procedure

Population: Analysis population Includes only the most serious event for each subject and includes only each subject's first occurrence of the event. Subjects who did not complete 30 day follow-up and did not have any death, stroke or MI events are excluded.

Outcome measures

Outcome measures
Measure
CAS Group
n=1072 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=348 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Death (Non-Hierarchical)
0.1 percentage of participants
Interval 0.0 to 0.5
0.3 percentage of participants
Interval 0.0 to 1.6

SECONDARY outcome

Timeframe: ≤ 30 Days Post Index Procedure

Population: Analysis population Includes only the most serious event for each subject and includes only each subject's first occurrence of the event. Subjects who did not complete 30 day follow-up and did not have any death, stroke or MI events are excluded.

Outcome measures

Outcome measures
Measure
CAS Group
n=1072 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=348 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
All Stroke (Non-Hierarchical)
2.8 percentage of participants
Interval 1.9 to 4.0
1.4 percentage of participants
Interval 0.5 to 3.3

SECONDARY outcome

Timeframe: ≤ 30 Days Post Index Procedure

Population: Analysis population Includes only the most serious event for each subject and includes only each subject's first occurrence of the event. Subjects who did not complete 30 day follow-up and did not have any death, stroke or MI events are excluded.

Outcome measures

Outcome measures
Measure
CAS Group
n=1072 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=348 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Myocardial Infarction (MI) (Non-Hierarchical)
0.5 percentage of participants
Interval 0.2 to 1.1
0.9 percentage of participants
Interval 0.2 to 2.5

SECONDARY outcome

Timeframe: ≤ 30 Days Post Index Procedure

Population: Analysis population Includes only the most serious event for each subject and includes only each subject's first occurrence of the event. Subjects who did not complete 30 day follow-up and did not have any death, stroke or MI events are excluded.

Outcome measures

Outcome measures
Measure
CAS Group
n=1072 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=348 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Death, Stroke or Myocardial Infarction (MI) (Hierarchical)
3.3 percentage of participants
Interval 2.3 to 4.5
2.6 percentage of participants
Interval 1.2 to 4.9

SECONDARY outcome

Timeframe: ≤ 30 Days Post Index Procedure

Population: Analysis population Includes only the most serious event for each subject and includes only each subject's first occurrence of the event. Subjects who did not complete 30 day follow-up and did not have any death, stroke or MI events are excluded.

Outcome measures

Outcome measures
Measure
CAS Group
n=1072 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=348 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Death or Stroke (Hierarchical)
2.9 percentage of participants
Interval 2.0 to 4.1
1.7 percentage of participants
Interval 0.6 to 3.7

SECONDARY outcome

Timeframe: ≤ 30 Days Post Index Procedure

Population: Analysis population Includes only the most serious event for each subject and includes only each subject's first occurrence of the event. Subjects who did not complete 30 day follow-up and did not have any death, stroke or MI events are excluded.

Outcome measures

Outcome measures
Measure
CAS Group
n=1072 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=348 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Death or Major Stroke (Hierarchical)
0.6 percentage of participants
Interval 0.2 to 1.2
0.6 percentage of participants
Interval 0.1 to 2.1

SECONDARY outcome

Timeframe: 0 to 5 years

Outcome measures

Outcome measures
Measure
CAS Group
n=1089 Participants
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 Participants
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Freedom From Death, Stroke and MI Within 30 Days and Ipsilateral Stroke From 31 Days to 5 Years
94.6 percentage of participants
94.8 percentage of participants

Adverse Events

CAS Group

Serious events: 376 serious events
Other events: 635 other events
Deaths: 0 deaths

CEA Group

Serious events: 118 serious events
Other events: 216 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
CAS Group
n=1089 participants at risk
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 participants at risk
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Injury, poisoning and procedural complications
Bleeding
0.64%
7/1089 • Number of events 8 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Injury, poisoning and procedural complications
Hematoma
0.37%
4/1089 • Number of events 4 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Injury, poisoning and procedural complications
Infection
0.28%
3/1089 • Number of events 6 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Injury, poisoning and procedural complications
Occlusion
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Injury, poisoning and procedural complications
Pseudoaneurysm
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Injury, poisoning and procedural complications
Vessel trauma
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Blood and lymphatic system disorders
Epistaxis
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Blood and lymphatic system disorders
GI bleed
1.4%
15/1089 • Number of events 15 • 1 year
2.2%
8/364 • Number of events 8 • 1 year
Blood and lymphatic system disorders
Genitourinary
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Blood and lymphatic system disorders
Vascular
0.00%
0/1089 • 1 year
0.55%
2/364 • Number of events 2 • 1 year
Blood and lymphatic system disorders
Anemia
1.2%
13/1089 • Number of events 15 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Cardiac disorders
Abnormal lab test
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Cardiac disorders
Arrhythmia
2.0%
22/1089 • Number of events 25 • 1 year
1.1%
4/364 • Number of events 5 • 1 year
Cardiac disorders
Cardiac arrest
0.46%
5/1089 • Number of events 5 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Cardiac disorders
Congestive heart failure
0.92%
10/1089 • Number of events 12 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Cardiac disorders
Coronary artery disease
5.2%
57/1089 • Number of events 70 • 1 year
5.8%
21/364 • Number of events 25 • 1 year
Cardiac disorders
Pulmonary hypertension
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Cardiac disorders
Structural heart disease
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Cardiac disorders
Myocardial infarction
1.3%
14/1089 • Number of events 16 • 1 year
1.4%
5/364 • Number of events 5 • 1 year
Vascular disorders
Hypertension
0.55%
6/1089 • Number of events 6 • 1 year
0.55%
2/364 • Number of events 2 • 1 year
Vascular disorders
Hypotension
0.64%
7/1089 • Number of events 8 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Vascular disorders
Syncope
0.37%
4/1089 • Number of events 4 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Nervous system disorders
Confusion
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Cranial nerve palsy
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Dizziness
0.09%
1/1089 • Number of events 1 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Nervous system disorders
Encephalopathy
0.00%
0/1089 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Nervous system disorders
Headache
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Hyperperfusion syndrome
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Neurologic other
1.2%
13/1089 • Number of events 13 • 1 year
0.82%
3/364 • Number of events 5 • 1 year
Nervous system disorders
Peripheral neuropathy
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Seizure
0.46%
5/1089 • Number of events 7 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Nervous system disorders
Subdural hematoma
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
TIA
0.64%
7/1089 • Number of events 8 • 1 year
0.55%
2/364 • Number of events 2 • 1 year
Nervous system disorders
Visual disturbance
0.28%
3/1089 • Number of events 3 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Ipsilateral major
0.64%
7/1089 • Number of events 7 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Nervous system disorders
Ipsilateral minor
1.8%
20/1089 • Number of events 20 • 1 year
1.6%
6/364 • Number of events 6 • 1 year
Nervous system disorders
Non-ipsilateral major
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Nervous system disorders
Non-ipsilateral minor
0.28%
3/1089 • Number of events 3 • 1 year
0.00%
0/364 • 1 year
Surgical and medical procedures
Anesthesia/Procedural medication related
0.00%
0/1089 • 1 year
0.55%
2/364 • Number of events 2 • 1 year
Surgical and medical procedures
Arrhythmia
1.6%
17/1089 • Number of events 18 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Surgical and medical procedures
Bleeding
1.0%
11/1089 • Number of events 11 • 1 year
0.00%
0/364 • 1 year
Surgical and medical procedures
Cranial nerve injury
0.18%
2/1089 • Number of events 2 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Surgical and medical procedures
Fluid overload
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Surgical and medical procedures
Headache
0.00%
0/1089 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Surgical and medical procedures
Heparin induced thrombocytopenia
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Surgical and medical procedures
Hypertension
0.46%
5/1089 • Number of events 6 • 1 year
1.9%
7/364 • Number of events 7 • 1 year
Surgical and medical procedures
Hypotension
6.3%
69/1089 • Number of events 69 • 1 year
1.9%
7/364 • Number of events 7 • 1 year
Surgical and medical procedures
Spasm
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Surgical and medical procedures
Urinary retention
0.09%
1/1089 • Number of events 1 • 1 year
0.55%
2/364 • Number of events 2 • 1 year
Surgical and medical procedures
Vessel trauma
0.64%
7/1089 • Number of events 7 • 1 year
0.00%
0/364 • 1 year
Vascular disorders
Abdominal Aortic Aneurysm
0.18%
2/1089 • Number of events 2 • 1 year
0.55%
2/364 • Number of events 2 • 1 year
Vascular disorders
Carotid artery disease
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Vascular disorders
Contralateral stenosis
0.64%
7/1089 • Number of events 7 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
Vascular disorders
Deep vein thrombosis
0.00%
0/1089 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Vascular disorders
Occlusion
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Vascular disorders
Peripheral vascular disease
3.8%
41/1089 • Number of events 56 • 1 year
3.0%
11/364 • Number of events 20 • 1 year
Vascular disorders
Pulmonary embolism
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Vascular disorders
Renal artery disease
0.92%
10/1089 • Number of events 10 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Vascular disorders
Restenosis
0.09%
1/1089 • Number of events 1 • 1 year
0.00%
0/364 • 1 year
Vascular disorders
Stenosis
0.28%
3/1089 • Number of events 3 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Vascular disorders
Target lesion restenosis
0.73%
8/1089 • Number of events 8 • 1 year
2.5%
9/364 • Number of events 10 • 1 year
Immune system disorders
Allergic reaction
0.18%
2/1089 • Number of events 2 • 1 year
0.00%
0/364 • 1 year
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Cancer
1.9%
21/1089 • Number of events 23 • 1 year
2.2%
8/364 • Number of events 10 • 1 year
Gastrointestinal disorders
Gastrointestinal
2.7%
29/1089 • Number of events 39 • 1 year
0.82%
3/364 • Number of events 3 • 1 year
General disorders
Genitourinary
2.3%
25/1089 • Number of events 28 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
Infections and infestations
Infection
2.1%
23/1089 • Number of events 25 • 1 year
1.6%
6/364 • Number of events 6 • 1 year
Psychiatric disorders
Mental health related
0.37%
4/1089 • Number of events 4 • 1 year
0.55%
2/364 • Number of events 3 • 1 year
Metabolism and nutrition disorders
Metabolic
0.92%
10/1089 • Number of events 10 • 1 year
0.27%
1/364 • Number of events 1 • 1 year
General disorders
Miscellaneous
1.3%
14/1089 • Number of events 14 • 1 year
1.1%
4/364 • Number of events 6 • 1 year
Musculoskeletal and connective tissue disorders
Musculoskeletal
3.8%
41/1089 • Number of events 45 • 1 year
1.9%
7/364 • Number of events 7 • 1 year
Respiratory, thoracic and mediastinal disorders
Respiratory
1.7%
19/1089 • Number of events 24 • 1 year
2.5%
9/364 • Number of events 9 • 1 year
General disorders
Trauma
1.2%
13/1089 • Number of events 15 • 1 year
1.6%
6/364 • Number of events 6 • 1 year

Other adverse events

Other adverse events
Measure
CAS Group
n=1089 participants at risk
CAS group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
CEA Group
n=364 participants at risk
CEA group: 3:1 ratio of Carotid Artery Stenting (CAS) versus Carotid Endarterectomy (CEA). Subjects will be followed at 30 days, six (6), and 12 months post-procedure, and annually for four (4) additional years.
Injury, poisoning and procedural complications
Anesthesia/Procedural medication related
6.0%
65/1089 • Number of events 70 • 1 year
14.0%
51/364 • Number of events 55 • 1 year
Injury, poisoning and procedural complications
Arrhythmia
12.9%
140/1089 • Number of events 148 • 1 year
5.5%
20/364 • Number of events 20 • 1 year
Injury, poisoning and procedural complications
Cranial nerve injury
1.3%
14/1089 • Number of events 15 • 1 year
13.2%
48/364 • Number of events 51 • 1 year
Injury, poisoning and procedural complications
Headache
6.7%
73/1089 • Number of events 74 • 1 year
8.2%
30/364 • Number of events 31 • 1 year
Injury, poisoning and procedural complications
Hypertension
3.7%
40/1089 • Number of events 40 • 1 year
8.0%
29/364 • Number of events 29 • 1 year
Injury, poisoning and procedural complications
Hypotension
23.1%
252/1089 • Number of events 268 • 1 year
9.6%
35/364 • Number of events 36 • 1 year
Injury, poisoning and procedural complications
Pain
5.1%
56/1089 • Number of events 60 • 1 year
17.6%
64/364 • Number of events 66 • 1 year
Gastrointestinal disorders
Other
8.5%
93/1089 • Number of events 115 • 1 year
9.1%
33/364 • Number of events 41 • 1 year
Infections and infestations
Other
7.4%
81/1089 • Number of events 92 • 1 year
6.3%
23/364 • Number of events 31 • 1 year
Metabolism and nutrition disorders
Other
4.7%
51/1089 • Number of events 58 • 1 year
6.6%
24/364 • Number of events 25 • 1 year
General disorders
Other
9.8%
107/1089 • Number of events 140 • 1 year
11.0%
40/364 • Number of events 47 • 1 year
Musculoskeletal and connective tissue disorders
Other
15.9%
173/1089 • Number of events 211 • 1 year
7.7%
28/364 • Number of events 36 • 1 year
Respiratory, thoracic and mediastinal disorders
Other
5.1%
56/1089 • Number of events 66 • 1 year
4.9%
18/364 • Number of events 20 • 1 year

Additional Information

Jennifer M Jones-McMeans, PhD (Associate Director Clinical Research)

Abbott Vascular

Phone: 408-845-1459

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60