6/28/23, 11:22 PM NASCET Pathway Feedback Search Clinical Topics Home Studies NASCET NASCET Disease Disease Disease Acute ischemic stroke Carotid artery stenosis Transient Trial question Is carotid endarterectomy superior to medical care alone in patients with moderate carotid stenosis and TIAs or nondisabling strokes ipsilateral to the stenosis (within 180 days)? Study design Multi-center Open label RCT Population Characteristics of study participants 29.6% female N = 2267 70.4% male 2267 patients (668 female, 1558 male) Inclusion criteria: patients with moderate carotid stenosis and TIAs or nondisabling strokes ipsilateral to the stenosis (within 180 days) Key exclusion criteria: lack of angiographic visualization of the symptomatic artery, nonatherosclerotic carotid disease, cardiac lesions likely to cause cardioembolism, or a history of ipsilateral endarterectomy Interventions N=1108 surgical therapy (carotid endarterectomy plus medical treatment) N=1118 medical therapy (medical care alone with antiplatelet medications, antihypertensives and antilipidemics as indicated) https://web.pathway.md/studies/recNSHWdOhMO60CJB 1/2 6/28/23, 11:22 PM NASCET Pathway Primary outcome Any ipsilateral stroke at 5 years, in patients with stenosis of 50-69% 22.2 % 22.2 16.6 % 15.7 11.1 % Significant decrease 5.5 % NNT = 15 0.0 % Surgical therapy Medical therapy Significant decrease in any ipsilateral stroke at 5 years, in patients with stenosis of 50-69% (15.7% vs. 22.2%; RR 0.7, 95% CI 0.48 to 0.93) Secondary outcomes No significant difference in any ipsilateral stroke at 5 years, in patients with < 50% stenosis (14.9% vs. 18.7%; RR 0.8, 95% CI -0.31 to 1.91) Conclusion In patients with moderate carotid stenosis and TIAs or nondisabling strokes ipsilateral to the stenosis (within 180 days), surgical therapy was superior to medical therapy with respect to any ipsilateral stroke at 5 years, in patients with stenosis of 50-69%. Reference Barnett HJ, Taylor DW, Eliasziw M et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1998 Nov 12;339(20):1415-25. Open reference URL https://web.pathway.md/studies/recNSHWdOhMO60CJB 2/2