SynthesisNeurology2015
Temporal trends in safety of carotid endarterectomy in asymptomatic patients: systematic review.
Synthesis in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Secular Trends in Procedural Stroke or Death Risks of Stenting Versus Endarterectomy for Symptomatic Carotid Stenosis.Circulation. Cardiovascular interventions · 2019Pooled it
- Meta-analysis of the procedural risks of carotid endarterectomy and carotid artery stenting over time.The British journal of surgery · 2018Pooled it
- Exploring a Prediction Model Based on Patient Record Data in Carotid Stenosis Risk Assessment.Vascular health and risk management · 2026Article
- Treatment and Procedures for Ischemic Strokes of Vascular Etiology: Experience of the Eastern Slovakia Stroke Center.Cureus · 2026Article
- Investigation of the hyperperfusion phenomenon following carotid artery stenting using preoperative computed tomography perfusion imaging.Acta neurochirurgica · 2025Article
- Comparative on the effectiveness and safety of different carotid endarterectomy techniques: a single-center Retrospective Study.Journal of cardiothoracic surgery · 2024Article
- CREST-2 Reaches A Surgical Milestone.Journal of vascular surgery · 2024Article
- Carotid plaque characteristics in the CREST-2 trial.JVS-vascular insights · 2024Article
- Extra-Cranial Carotid Artery Stenosis: An Objective Analysis of the Available Evidence.Frontiers in neurology · 2022Review
- Roadmap Consensus on Carotid Artery Plaque Imaging and Impact on Therapy Strategies and Guidelines: An International, Multispecialty, Expert Review and Position Statement.AJNR. American journal of neuroradiology · 2021Article
- Intraoperative completion studies in carotid endarterectomy: systematic review and meta-analysis of techniques and outcomes.Annals of translational medicine · 2021Article
- Review of imaging biomarkers for the vulnerable carotid plaque.JVS-vascular science · 2021Review
- Carotid artery stenosis screening: where are we now?The British journal of radiology · 2018Review
- Review
- Carotid Endarterectomy and Carotid Artery Stenting in the US Medicare Population, 1999-2014.JAMA · 2017Article
- Evidence-Based Carotid Interventions for Stroke Prevention: State-of-the-art Review.Journal of atherosclerosis and thrombosis · 2017Review
- The urgent need for contemporary clinical trials in patients with asymptomatic carotid stenosis.Neurology · 2016Review
- Interventions for Extracranial Carotid Artery Stenosis: An Update.Current treatment options in cardiovascular medicine · 2016Review
- Bias in the use of randomized trials for carotid stenosis management.Gefasschirurgie : Zeitschrift fur vaskulare und endovaskulare Chirurgie : Organ der Deutschen und der Osterreichischen Gesellschaft fur Gefasschirurgie unter Mitarbeit der Schweizerischen Gesellschaft fur GefasschirurgieArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo systematically review temporal changes in perioperative safety of carotid endarterectomy (CEA) in asymptomatic individuals in trial and registry studies.
methodsThe MEDLINE and EMBASE databases were searched using the terms "carotid" and "endarterectomy" and "asymptomatic" from 1947 to August 23, 2014. Articles dealing with 50%-99% stenosis in asymptomatic individuals were included and low-volume studies were excluded. The primary endpoint was 30-day stroke or death and the secondary endpoint was 30-day all-cause mortality. Statistical analysis was performed using random-effects meta-regression for registry data and for trial data graphical interpretation alone was used.
resultsSix trials (n = 4,431 procedures) and 47 community registries (n = 204,622 procedures) reported data between 1983 and 2013. Registry data showed a significant decrease in postoperative stroke or death incidence over the period 1991-2010, equivalent to a 6% average proportional annual reduction (95% credible interval [CrI] 4%-7%; p < 0.001). Considering postoperative all-cause mortality, registry data showed a significant 5% average proportional annual reduction (95% CrI 3%-9%; p < 0.001). Trial data showed a similar visual trend.
conclusionsCEA is safer than ever before and high-volume registry results closely mirror the results of trials. New benchmarks for CEA are a stroke or death risk of 1.2% and a mortality risk of 0.4%. This information will prove useful for quality improvement programs, for health care funders, and for those re-examining the long-term benefits of asymptomatic revascularization in future trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.