Journal of Vascular Surgery
Volume 44, Issue 2 , Pages 258-268 , August 2006

Protected carotid stenting in high-surgical-risk patients: The ARCHeR results

Presented at the American College of Cardiology Annual Scientific session, March 7–10, 2004, New Orleans, LA.

  • William A. Gray, MD

      Affiliations

    • Columbia University Medical Center, New York, NY
    • Corresponding Author InformationReprint requests: William A. Gray, MD, Center for Interventional Vascular Therapy/Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY 10032
    • ,
  • L. Nelson Hopkins, MD

      Affiliations

    • Millard Fillmore Hospital, Buffalo, NY
    • ,
  • Sanjay Yadav, MD

      Affiliations

    • The Cleveland Clinic Foundation, Cleveland, Ohio
    • ,
  • Thomas Davis, MD

      Affiliations

    • St John Hospital, Detroit, Mich
    • ,
  • Mark Wholey, MD

      Affiliations

    • University of Pittsburgh, Pittsburgh, Penn
    • ,
  • Richard Atkinson, MD

      Affiliations

    • University of California at Davis, Sacramento, Calif
    • ,
  • Alberto Cremonesi, MD

      Affiliations

    • Villa Maria Cecilia Hospital, Cotignola (Ravenna), Ravenna, Italy
    • ,
  • Ronald Fairman, MD

      Affiliations

    • Hospital at University of Pennsylvania, Philadelphia, Penn
    • ,
  • Gary Walker, PhD

      Affiliations

    • Guidant Endovascular Solutions, Santa Clara
    • ,
  • Patrick Verta, MD

      Affiliations

    • Guidant Endovascular Solutions, Santa Clara
    • ,
  • Jeff Popma, MD

      Affiliations

    • Brigham and Women’s Hospital, Boston, Mass
    • ,
  • Renu Virmani, MD

      Affiliations

    • Armed Forces Institute of Pathology, Bethesda, Md
    • ,
  • David J. Cohen, MD, MSc

      Affiliations

    • Harvard Clinical Research Institute, Boston, Mass
    • ,
  • ARCHeR Trial Collaborators

      Affiliations

    • Other collaborators of the ARCHeR trial are listed in Appendix I.

Received 11 January 2006 ,Accepted 30 March 2006.

References 

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  4. Nascet C  North American Symptomatic Carotid Endarterectomy Trial Collaborators . Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis . N Engl J Med . 1991;325:445–453
  5. Halliday A , Mansfield A , Marro J , Peto C , Peto R , Potter J , et al.  MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group   Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms (randomised controlled trial) . Lancet . 2004;363:1491–1502
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  8. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study . Endarterectomy for asymptomatic carotid artery stenosis . JAMA . 1995;273:1421–1428
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  12. Gasecki AP , Eliasziw M , Ferguson GG , Hachinski V , Barnett HJ  North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group . Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion (results from NASCET) . J Neurosurg . 1995;83:778–782
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  16. Meyer FB , Piepgras DG , Fode NC . Recurrent carotid stenosis . In:  Meyer FB editors. Sundt’s occlusive cerebrovascular disease . Philadelphia: WB Saunders; 1994;p. 310–321
  17. Rigdon EE , Monajjem N , Rhodes RS . Is carotid endarterectomy justified in patients with severe chronic renal insufficiency? . Ann Vasc Surg . 1997;11:115–119
  18. Vassilidze TV , Cernaianu AC , Gaprindashvili T , Gallucci JG , Cilley JH , DelRossi AJ . Simultaneous coronary artery bypass and carotid endarterectomy (Determinants of outcome) . Tex Heart Inst J . 1994;21:119–124
  19. Wong JH , Findlay JM , Suarez-Almazor ME . Regional performance of carotid endarterectomy (Appropriateness, outcomes, and risk factors for complications) . Stroke . 1997;28:891–898
  20. McCrory DC , Goldstein LB , Samsa GP , Oddone EZ , Landsman PB , Moore WS , et al.   Predicting complications of carotid endarterectomy . Stroke . 1993;24:1285–1291
  21. Yadav JS , Wholey MH , Kuntz RE , Fayad P , Katzen BT , Mishkel GJ , et al.   Stenting and Angioplasty With Protection in Patients at High Risk for Endarterectomy Investigators (Protected carotid-artery stenting versus endarterectomy in high-risk patients) . N Engl J Med . 2004;351:1493–1501
  22. Tu JV , Wang H , Bowyer B , Green L , Fang J , Kucey D . Risk factors for death or stroke after carotid endarterectomy (observations from the Ontario Carotid Endarterectomy Registry) . Stroke . 2003;34:2568–2573
  23. Ouriel K , Hertzer NR , Beven EG , O’hara PJ , Krajewski LP , Clair DG , et al.   Preprocedural risk stratification (identifying an appropriate population for carotid stenting) . J Vasc Surg . 2001;33:728–732
  24. Naylor AR , Cuffe RL , Rothwell PM , Bell PR . A systematic review of outcomes following staged and synchronous carotid endarterectomy and coronary artery bypass . Eur J Vasc Endovasc Surg . 2003;25:380–389
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  29. Manninen HI , Rasanen HT , Vanninen RL , Vainio P , Hippelainen M , Kosma VM . Stent placement versus percutaneous transluminal angioplasty of human carotid arteries in cadavers in situ (distal embolization and findings at intravascular US, MR imaging and histopathologic analysis) . Radiology . 1999;212:483–492
  30. McCleary AJ , Nelson M , Dearden NM , Calvey TA , Gough MJ . Cerebral haemodynamics and embolization during carotid angioplasty in high-risk patients . Br J Surg . 1998;85:771–774

 The ARCHeR trials were funded by Guidant Corporation (Santa Clara, Calif).

 Competition of interest: The authors below, along with authors not listed here, may have relationships with other companies which were not deemed in conflict with the reporting of the results of this trial. Specific to the sponsor of the study, the following disclosures are made: Dr Walker, Guidant employee; Dr Verta, Guidant employee; Dr Atkinson, consultant to Guidant; Dr Fairman, research grant support from Guidant; Dr Wholey, consultant to Guidant; Dr Hopkins, research grant support from Guidant; Dr Cohen, consultant to Guidant; Dr Virmani, consultant to Guidant; and Dr Gray, consultant to Guidant.

PII: S0741-5214(06)00745-2

doi: 10.1016/j.jvs.2006.03.044

Journal of Vascular Surgery
Volume 44, Issue 2 , Pages 258-268 , August 2006

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