Collaboration between the chief investigators of the carotid stenting trials to pool the results from individual patients in order to compare the safety of catheter based stent insertion with surgical operation

Institution:
The National Hospital for Neurology & Neurosurgery, Queen Square, London
Principal Investigator:
Prof M Brown
Region: London
Grant value: £63,990 over 12 months
Start date: July 2008
Status: ongoing

Some stroke survivors are diagnosed with carotid stenosis (a narrowing of the carotid artery which is the major blood supplier to the brain). Without treatment, the risk of having another stroke is very high. Surgery to open the artery and remove the stenosis is currently the most common treatment; however, an alternative treatment is to use a small tube made of mesh wire to reopen the carotid stenosis without major surgery. This process is called stenting. However, there is a risk that both surgery and stenting may cause stroke or other complications at the time of treatment.

There are currently four different studies comparing the risks and benefits of stenting and surgery for carotid stenosis. However, to be certain that stenting can be safely carried out instead of surgery a large number of stroke survivors are needed to take part in the study. Furthermore, it is possible that stroke survivors may respond differently to stenting and surgery depending on factors such as age, gender and how blocked their artery is. This means a very large sample is needed to show any individual differences.

The investigators of the four studies are combining their data to determine whether stenting is a safe alternative to surgery, and which treatment is most suitable for which patients. The results of this project may help healthcare professionals to choose the optimal treatment for individual patients.

Scientific Title: Carotid stenting trialists collaboration: a meta-analysis of individual patient safety data

 

Classification:
Prevention, Surgical Treatment