Carotid artery stenting versus carotid endarterectomy - a prospective randomised controlled single-centre trial with long-term follow-up (BACASS)

Background and objective: Safety and effectiveness of carotid artery stenting (CAS) was compared with carotid endarterectomy (CEA) in a singlecentre prospective randomised controlled trial in symptomatic high-grade stenosis of the ICA. Material and methods: Twenty patients with symptomatic ICA stenosis 70% were prospectively randomised to either CAS or CEA. Primary outcome measures were periprocedural stroke, death or myocardial infarction. Secondary outcome measures were peri-interventional transient TIA, bleeding complications, cranial nerve paralysis, length of stay and ICA patency as well as stroke or death during long-term follow-up. Results: CAS patients had no peri-interventional complications. In the CEA group 1/10 had an ipsilateral non-disabling stroke after 16 days. During long-term follow-up (48.1 21.3 months with CAS and 43.5 19.5 months with CEA) neither strokes nor myocardial infarctions occurred in both groups. Length of stay was 3.5 1.8 days for CAS versus 7.3 3.3 days for CEA patients. CEA and CAS groups did not differ in other secondary outcome measures. Conclusion: CAS and CEA seem to be comparably safe in our setting. More importantly, data useful for a systematic meta-analysis are provided, which include long-term results.