Six RCTs (n=1,263) were included in the review. Two of these RCTs had been stopped early (n=236). The authors identified four ongoing RCTs.
Thirty-day death or stroke.
There was no statistically significant difference in combined deaths or stroke rate within 30 days between CAS and CEA (8% versus 6.1%, OR 1.36, 95% CI: 0.88, 2.11; P=0.17; 5 RCTs). There was evidence of statistically significant heterogeneity (P=0.009). Following the exclusion of the smallest study, which had a particularly high death or stroke rate after CAS and was stopped early, statistically significant heterogeneity was no longer observed (P=0.18) and there was no statistically significant difference between CAS and CEA (OR 1.19, 95% CI: 0.76, 1.85; P=0.45).
Follow-up death or stroke.
There was no statistically significant difference in combined deaths or stroke rate at follow-up between CAS and CES (12.1% versus 12.2%, OR 0.99, 95% CI: 0.70, 1.42; P=0.98). There was evidence of statistically significant heterogeneity (P=0.02).
Secondary outcomes.
The rate of cranial nerve palsy and 30-day myocardial infarction were significantly greater after CEA than CAS (P<0.0001 and P=0.02, respectively).