Introduction

Clinical trials have shown that carotid surgery on patients with symptomatic severe carotid stenosis prevents stroke but also has significant morbidity. Stenting has become an established alternative treatment for coronary and peripheral vascular disease and has the advantage of avoiding general anaesthesia and neck incision. In July 1997, randomisation was completed in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS). The results did not show a difference in the major risks or benefits of carotid angioplasty and surgery, but the trial did show that both methods still carry a significant risk of causing a stroke. Techniques of carotid angioplasty have improved and stenting is increasingly used. We have started the International Carotid Stenting Study (ICSS) as a follow-on study to CAVATAS.

ICSS is an international, multicentre, randomised, controlled, open, prospective clinical trial evaluating primary stenting of carotid artery stenosis in patients with symptomatic disease in comparison to endarterectomy.

For more details see the protocol.

The interim safety analysis of the ICSS has now been published in the Lancet and may be accessed here . 

The results of the MRI substudy examining the occurrence of brain lesions after stenting or endarterectomy have been published in Lancet Neurology and may be accessed here . 

The ICSS has been funded by research grants from the Medical Research Council UK, The Stroke Association, Sanofi-Synthélabo and the European Union.

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