"Currently, the choice of CEA versus CAS in individual patients is based more on individual practitioner experience than on clear evidence-derived guidelines," according to the new article by Drs. Philip P. Goodney and Richard J. Powell of Dartmouth-Hitchcock Medical Center, Lebanon, N.H. "Nonetheless, the popularity of less-invasive therapy combined with marketing of new CAS systems has increased the utilization of CAS."
Drs. Goodney and Powell review and summarize the research evidence on CAS to prevent stroke in patients with narrowing (stenosis) of the carotid arteries. In the CAS procedure, an expandable mesh device called a stent is placed to increase blood flow through the area of stenosis.
Recently, several randomized controlled trials—the strongest category of scientific evidence—have directly compared the results of CAS and CEA. It has now been fairly well established that CAS and CEA yield comparable results in "high-risk" patients.
However, debate continues as to the role of CAS in the much larger group of "low-risk" patients. Some studies suggest that CAS and CEA produce similar results, but others have found a lower rate of serious complications and death in patients undergoing surgery.
Drs. Goodney and Powell note several limitations of the research that make it difficult to compare results between trials. Studies being conducted now will help to clarify the relative performance of the two techniques in both high-risk and low-risk patients. A key question will be whether CAS or CEA is the better choice for patients considered high-risk because of medical conditions.
Other issues that will need to be worked through include refinements in the design of CAS systems and the role of detailed imaging studies in guiding treatment decisions. "Ongoing randomized trials will help determine optimal revascularization strategies in the future," the authors conclude.
Jayne Dawkins | alfa
Discovery shows promise for treating Huntington's Disease
05.08.2020 | Ecole Polytechnique Fédérale de Lausanne
Carbon monoxide improves endurance performance
05.08.2020 | Universität Bayreuth
Scientists at the Fraunhofer Institute for Laser Technology ILT have come up with a striking new addition to contact stamping technologies in the ERDF research project ScanCut. In collaboration with industry partners from North Rhine-Westphalia, the Aachen-based team of researchers developed a hybrid manufacturing process for the laser cutting of thin-walled metal strips. This new process makes it possible to fabricate even the tiniest details of contact parts in an eco-friendly, high-precision and efficient manner.
Plug connectors are tiny and, at first glance, unremarkable – yet modern vehicles would be unable to function without them. Several thousand plug connectors...
An international research team has found a new approach that may be able to reduce bone loss in osteoporosis and maintain bone health.
Osteoporosis is the most common age-related bone disease which affects hundreds of millions of individuals worldwide. It is estimated that one in three women...
Traditional single-cell sequencing methods help to reveal insights about cellular differences and functions - but they do this with static snapshots only...
“Core-shell” clusters pave the way for new efficient nanomaterials that make catalysts, magnetic and laser sensors or measuring devices for detecting electromagnetic radiation more efficient.
Whether in innovative high-tech materials, more powerful computer chips, pharmaceuticals or in the field of renewable energies, nanoparticles – smallest...
An international research team with Prof. Cornelia Denz from the Institute of Applied Physics at the University of Münster develop for the first time light fields using caustics that do not change during propagation. With the new method, the physicists cleverly exploit light structures that can be seen in rainbows or when light is transmitted through drinking glasses.
Modern applications as high resolution microsopy or micro- or nanoscale material processing require customized laser beams that do not change during...
23.07.2020 | Event News
21.07.2020 | Event News
07.07.2020 | Event News
06.08.2020 | Earth Sciences
06.08.2020 | Power and Electrical Engineering
06.08.2020 | Life Sciences