title: [Treatment of asymptomatic carotid artery stenosis: improvement of evidence with new SPACE-2 design necessary].
abstract: Asymptomatic carotid artery stenosis may be treated with carotid endarterectomy (CEA), carotid artery stenting (CAS) or with best medical treatment (BMT) only. Definitive and evidence-based treatment recommendations for one of these options are currently not possible. Studies showing an advantage of CEA over BMT alone do not meet current standards from a pharmacological point of view. On the other hand, more recent data point to a further stroke risk reduction using BMT according to current standards. Studies on carotid artery stenting as a third alternative treatment are partially insufficient, especially when comparing CAS with BMT. Initiated in 2009, the randomized, controlled, multicenter SPACE-2 trial is intended to answer the question about the best treatment option of asymptomatic carotid artery stenosis; however, to increase recruitment rates as a condition for the successful completion of this important study, the trial design had to be modified.
authors: -, -, -, Tilman.Reiff@med.uni-heidelberg.de.
authors: T
authors: T
authors: Reiff
authors: H
authors: H
authors: Amiri
authors: P A
authors: PA
authors: Ringleb
authors: O
authors: O
authors: Jansen
authors: W
authors: W
authors: Hacke
authors: H H
authors: HH
authors: Eckstein
authors: G
authors: G
authors: Fraedrich
authors: H
authors: H
authors: Mudra
authors: U
authors: U
authors: Mansmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002423:Cause of Death; D016894:Endarterectomy, Carotid; D005060:Europe; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012008:Recurrence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D015607:Stents; D015996:Survival Rate
chemical_list: D002317:Cardiovascular Agents