Stroke Trials Registry

ACAS
Asymptomatic Carotid Atherosclerosis Study

Trial Phase:	Phase III
Study Size Actual:	1662
Centers Actual:	39
Max Time from onset:	-1

Status:
Trial complete. Results published in 1995.

Purpose:
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.

Interventions:

Endarterectomy, carotid
Surgical therapy to remove atherosclerotic plaque in narrowed carotid arteries.

Year Published: 1995

Design:
Prospective, randomized, multicenter trial of 1662 patients at 39 centers.

Inclusion Criteria
Asymptomatic carotid artery stenosis of 60% or greater reduction in diameter.

Patient Involvement:
Daily aspirin administration and medical risk factor management for all patients, carotid endarterectomy for patients randomized to receive surgery. Patients were followed for

Primary Outcome:
Cerebral infarction occurring in the distribution of the study artery or any stroke or death occurring the perioperative period.

Results:
Aggregate risk 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.

Source of Information:
JAMA 1995 May 10; 273(18):1421-8

Web Links and Publications:

Carotid endarterectomy for asymptomatic carotid stenosis: asymptomatic carotid surgery trial.
Stroke 2004 Oct;35(10):2425-7

Low mini-mental status predicts mortality in asymptomatic carotid arterial stenosis.
Neurology. 2000 Jul 12;55(1):30-34.

Recurrent carotid stenosis : results of the asymptomatic carotid atherosclerosis study.
Stroke 1998 Oct;29(10):2018-25

The delay in reporting symptoms of carotid artery stenosis in an at-risk population. The Asymptomatic Carotid Atherosclerosis Study experience: a statement of concern regarding watchful waiting.
Arch Neurol. 1997 Oct;54(10):1267-71.

Consistency of Doppler parameters in predicting arteriographically confirmed carotid stenosis. Asymptomatic Carotid Atherosclerosis Study Investigators.
Stroke 1997 Feb;28(2):343-7.

An analysis of perioperative surgical mortality and morbidity in the asymptomatic carotid atherosclerosis study. ACAS Investigators. Asymptomatic Carotid Artheriosclerosis Study.
Stroke 1996 Dec;27(12):2216-24

Surgical results: a justification of the surgeon selection process for the ACAS trial. The ACAS Investigators.
J Vasc Surg. 1996 Feb;23(2):323-8.

Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study.
JAMA 1995 May 10;273(18):1421-1428

Baseline silent cerebral infarction in the Asymptomatic Carotid Atherosclerosis Study.
Stroke 1994 Jun;25(6):1122-9.

Selection process for surgeons in the Asymptomatic Carotid Atherosclerosis Study.
Stroke 1991 Nov;22(11):1353-7.

Study design for randomized prospective trial of carotid endarterectomy for asymptomatic atherosclerosis. The Asymptomatic Carotid Atherosclerosis Study Group.
Stroke 1989 Jul;20(7):844-9.

This information last updated on: 8/3/2000

Reviewed on: 11/04/2005.

UID: 89