Thrombi of different pathologies: Implications for diagnosis and treatment

Current Treatment Options in Cardiovascular Medicine

Volumn 12, Issue 3, 2010, Pages 274-291

  Santos Gallego, Carlos G ^a   Bayón, Jeremías ^b   Badimón, Juan José ^a  

^a MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^b HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS   (Spain)

Author keywords

[No Author keywords available]

Indexed keywords

ACETAZOLAMIDE; ACETYLSALICYLIC ACID; ALTEPLASE; ANTICOAGULANT AGENT; ANTIDIABETIC AGENT; ANTITHROMBOCYTIC AGENT; APIXABAN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CILOSTAZOL; CLOPIDOGREL; DABIGATRAN; DABIGATRAN ETEXILATE; DIPYRIDAMOLE; DRONEDARONE; FIBRINOLYTIC AGENT; FLUOXETINE; IRBESARTAN; KETOCONAZOLE; METHOTREXATE; NONSTEROID ANTIINFLAMMATORY AGENT; OMEPRAZOLE; PLACEBO; PRASUGREL; PSYCHOSTIMULANT AGENT; RIVAROXABAN; TERUTROBAN; TISSUE PLASMINOGEN ACTIVATOR; UNINDEXED DRUG; VALPROIC ACID; WARFARIN;

ALCOHOL CONSUMPTION; ANGIONEUROTIC EDEMA; ANTICOAGULANT THERAPY; ASTHMA; ATHEROSCLEROSIS; BLEEDING; BLEEDING DISORDER; BODY MASS; BRAIN ATHEROSCLEROSIS; BRAIN EDEMA; BRAIN HEMORRHAGE; BRAIN HERNIA; BRAIN ISCHEMIA; BRONCHOSPASM; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CAROTID ANGIOPLASTY; CAROTID ARTERY STENTING; CAROTID ARTERY SURGERY; CAROTID ATHEROSCLEROSIS; CAROTID ENDARTERECTOMY; CATHETER ABLATION; CATHETER OCCLUSION; CIGARETTE SMOKING; CLINICAL EVALUATION; CLINICAL TRIAL; CLIP; COST EFFECTIVENESS ANALYSIS; CREATININE BLOOD LEVEL; DIET; DRUG ACTIVITY; DRUG CONTRAINDICATION; DRUG COST; DRUG EFFICACY; DRUG HYPERSENSITIVITY; DRUG INDUCED HEADACHE; DRUG SAFETY; DYSPEPSIA; EMBOLISM; EPISTAXIS; EXERCISE; FOOD INTAKE; FRUIT; GASTROINTESTINAL HEMORRHAGE; GASTROINTESTINAL SYMPTOM; GOUT; HEADACHE; HEART ATRIUM APPENDAGE; HEART ATRIUM FIBRILLATION; HEART ATRIUM FLUTTER; HEART INFARCTION; HUMAN; HYPERTENSION; HYPOTENSION; INTERMETHOD COMPARISON; INTERNATIONAL NORMALIZED RATIO; KIDNEY DISEASE; KIDNEY DYSFUNCTION; LIFESTYLE MODIFICATION; LIVER DISEASE; LIVER DYSFUNCTION; NAUSEA AND VOMITING; NEUTROPENIA; PEPTIC ULCER; PREGNANCY; PRURITUS; PURPURA; RASH; RECANALIZATION; REVIEW; RISK FACTOR; SEIZURE; SIDE EFFECT; SKIN NECROSIS; SMOKING CESSATION; STROKE; THROMBOEMBOLISM; THROMBOGENESIS; THROMBOSIS; THROMBOTIC THROMBOCYTOPENIC PURPURA; TRANSIENT ISCHEMIC ATTACK; TREATMENT CONTRAINDICATION; TREATMENT OUTCOME; TREATMENT PLANNING; UNSTABLE ANGINA PECTORIS; URTICARIA; VASCULITIS; VEGETABLE; VIRUS INFECTION; VITAMIN SUPPLEMENTATION;

EID: 77953542125     PISSN: 10928464     EISSN: None     Source Type: Journal    
DOI: 10.1007/s11936-010-0075-8     Document Type: Review

References (92)

1. Lopez AD, Mathers CD, Ezzati M, et al.: Global andregional burden of disease and risk factors, 2001:systematic analysis of population health data.Lancet 2006, 367:1747-1757.
2. Badimon JJ, Ibanez B, Cimmino G: Genesis anddynamics of atherosclerotic lesions: implicationsfor early detection. Cerebrovasc Dis 2009, 27(Suppl1):38-47.This is an interesting and thorough review of the atherothromboticprocess and its evaluation by means of imagingtechniques.
3. Macleod MR, Amarenco P, Davis SM, Donnan GA: Atheroma of the aortic arch: An important andpoorly recognised factor in the aetiology of stroke.Lancet Neurol 2004, 3:408-414.
4. Marder VJ, Chute DJ, Starkman S, et al.: Analysis ofthrombi retrieved from cerebral arteries of patientswith acute ischemic stroke. Stroke 2006, 37:2086-2093.
5. Mohr JP, Thompson JL, Lazar RM, et al.: A comparisonof warfarin and aspirin for the prevention ofrecurrent ischemic stroke. N Engl J Med 2001, 345:1444-1451.
6. Chimowitz MI, Lynn MJ, Howlett-Smith H, et al.:Comparison of warfarin and aspirin for symptomaticintracranial arterial stenosis. N Engl J Med 2005, 352:1305-1316.
7. Molina CA, Montaner J, Arenillas JF, et al.: Differentialpattern of tissue plasminogen activatorinducedproximal middle cerebral arteryrecanalization among stroke subtypes. Stroke 2004, 35:486-490.
8. Cho KH, Kim JS, Kwon SU, et al.: Significance of susceptibility vessel sign on T2*-weighted gradientecho imaging for identification of stroke subtypes.Stroke 2005, 36:2379-2383.
9. Kurth T, Moore SC, Gaziano JM, et al.: Healthy lifestyleand the risk of stroke in women. Arch InternMed 2006, 166:1403-1409.
10. Kurth T, Gaziano JM, Rexrode KM, et al.: Prospectivestudy of body mass index and risk of stroke in apparentlyhealthy women. Circulation 2005, 111:1992-1998.
11. Lee CD, Folsom AR, Blair SN: Physical activity andstroke risk: A meta-analysis. Stroke 2003, 34:2475-2481.
12. Reynolds K, Lewis B, Nolen JD, et al.: Alcohol consumptionand risk of stroke: A meta-analysis. JAMA2003, 289:579-588.
13. Shinton R, Beevers G: Meta-analysis of relation betweencigarette smoking and stroke. BMJ 1989, 298:789-794.
14. Qureshi AI, Suri MF, Kirmani JF, Divani AA: Cigarettesmoking among spouses: Another risk factorfor stroke in women. Stroke 2005, 36:e74-e76.
15. Joshipura KJ, Ascherio A, Manson JE, et al.: Fruit andvegetable intake in relation to risk of ischemicstroke. JAMA 1999, 282:1233-1239.
16. He K, Song Y, Daviglus ML, et al.: Fish consumptionand incidence of stroke: A meta-analysis of cohortstudies. Stroke 2004, 35:1538-1542.
17. Hsia J, Heiss G, Ren H, et al.: Calcium/vitamin Dsupplementation and cardiovascular events. Circulation2007, 115:846-854.This randomized trial in postmenopausal women (N=36, 282) assessed the risk of coronary and cerebrovascularevents from supplementation with calcium plus vitamin D. Stroke was confirmed in 362 women assigned to calcium/vitamin D and 377 assigned to placebo (hazard ratio, 0.95;95% CI, 0.82-1.10).
18. Tornwall ME, Virtamo J, Korhonen PA, et al.: Postinterventioneffect of alpha tocopherol and betacarotene on different strokes: A 6-year follow-up ofthe Alpha Tocopherol, Beta Carotene Cancer PreventionStudy. Stroke 2004, 35:1908-1913.
19. Miller 3rd ER, Pastor-Barriuso R, Dalal D, et al.:Meta-analysis: high-dosage vitamin E supplementationmay increase all-cause mortality. Ann InternMed 2005, 142:37-46.
20. Bartolucci AA, Howard G: Meta-analysis of datafrom the six primary prevention trials of cardiovascularevents using aspirin. Am J Cardiol 2006, 98:746-750.
21. Ridker PM, Cook NR, Lee IM, et al.: A randomizedtrial of low-dose aspirin in the primary preventionof cardiovascular disease in women. N Engl J Med2005, 352:1293-1304.
22. Berger JS, Roncaglioni MC, Avanzini F, et al.: Aspirinfor the primary prevention of cardiovascular eventsin women and men: A sex-specific meta-analysis ofrandomized controlled trials. JAMA 2006, 295:306-313.
23. Hobson 2nd RW, Krupski WC, Weiss DG: Influenceof aspirin in the management of asymptomaticcarotid artery stenosis. VA Cooperative StudyGroup on Asymptomatic Carotid Stenosis. J VascSurg 1993, 17:257-263. discussion 263-265.
24. Engelter S, Lyrer P: Antiplatelet therapy for preventingstroke and other vascular events after carotidendarterectomy. Cochrane Database Syst Rev2003, CD001458.
25. Weimar C, Weber R, Diener HC: Antithromboticmedication for stroke prevention. Expert Rev CardiovascTher 2009, 7:1245-1254.
26. Hart RG, Pearce LA, Aguilar MI: Meta-analysis: Antithrombotic therapy to prevent stroke inpatients who have nonvalvular atrial fibrillation.Ann Intern Med 2007, 146:857-867.This landmark study and updated meta-analysis of the roleof antithrombotic treatment in nonvalvular AF comparedthe effectiveness of antiplatelet and anticoagulant drugs.
27. Fuster V, Rydén LE, Asinger RW, et al.: AmericanCollege of Cardiology/American Heart AssociationTask Force on Practice Guidelines; European Societyof Cardiology Committee for Practice Guidelinesand Policy Conferences (Committee toDevelop Guidelines for the Management ofPatients With Atrial Fibrillation); North AmericanSociety of Pacing and Electrophysiology: ACC/AHA/ESC Guidelines for the Management ofPatients With Atrial Fibrillation: Executive SummaryA Report of the American College of Cardiology/American Heart Association Task Force onPractice Guidelines and the European Society ofCardiology Committee for Practice Guidelines andPolicy Conferences (Committee to DevelopGuidelines for the Management of Patients WithAtrial Fibrillation) Developed in CollaborationWith the North American Society of Pacing andElectrophysiology. Circulation 2001, 104:2118-2150.
28. Bhatt DL, Fox KA, Hacke W, et al.: Clopidogrel andaspirin versus aspirin alone for the prevention ofatherothrombotic events. N Engl J Med 2006, 354:1706-1717.
29. CAPRIE Steering Committee: A randomised, blinded, trial of clopidogrel versus aspirin inpatients at risk of ischaemic events (CAPRIE).Lancet 1996, 348:1329-1339.
30. Hankey GJ, Eikelboom JW: Antithrombotic drugsfor patients with ischaemic stroke and transientischaemic attack to prevent recurrent major vascularevents. Lancet Neurol 2010, 9:273-284.The authors provide an excellent review of the bulk ofantithrombotic treatment in ischemic stroke.
31. Diener HC, Bogousslavsky J, Brass LM, et al.: Aspirinand clopidogrel compared with clopidogrel aloneafter recent ischemic stroke or transient ischemicattack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004, 364:331-337.
32. Yusuf S, Zhao F, Mehta SR, et al.: Effects of clopidogrelin addition to aspirin in patients with acutecoronary syndromes without ST-segment elevation.N Engl J Med 2001, 345:494-502.
33. Connolly S, Pogue J, Hart R, et al.: Clopidogrel plusaspirin versus oral anticoagulation for atrial fibrillationin the Atrial fibrillation Clopidogrel Trialwith Irbesartan for prevention of Vascular Events(ACTIVE W): A randomised controlled trial. Lancet2006, 367:1903-1912.
34. Connolly SJ, Pogue J, Hart RG, et al.: Effect of clopidogreladded to aspirin in patients with atrialfibrillation. N Engl J Med 2009, 360:2066-2078.This randomized trial of 7554 AF patients for whom vitamin Kantagonist therapy was unsuitable (eg, because of comorbidities, risk of falls, or inadequate laboratory facilities) assignedsubjects to receive clopidogrel (75 mg) or placebo, once daily, in addition to aspirin. The authors showed that the addition ofclopidogrel to aspirin reduced the risk ofmajor vascular events, especially stroke, and increased the risk of major hemorrhage.
35. Gilard M, Arnaud B, Cornily JC, et al.: Influence ofomeprazole on the antiplatelet action of clopidogrelassociated with aspirin: the randomized, doubleblindOCLA (Omeprazole CLopidogrel Aspirin)study. J AmColl Cardiol 2008, 51:256-260.This double-bind randomized trial concluded that omeprazolesignificantly decreased clopidogrel's inhibitory effect on plateletP2Y12, as assessed by vasodilator-stimulated phosphoproteinassay.
36. O'Donoghue ML, Braunwald E, Antman EM, et al.:Pharmacodynamic effect and clinical efficacy ofclopidogrel and prasugrel with or without aproton-pump inhibitor: An analysis of two randomisedtrials. Lancet 2009, 374:989-997.This retrospective analysis of PRINCIPLE-TIMI 44 and TRITONTIMI
37. Bhatt DL: COGENT: A prospective randomized placebo-controlled trial of omeprazole in patients receivingaspirin and clopidogrel. Presented atTranscatheter Cardiovascular Therapeutics. SanFrancisco, California; 2009.In the COGENT trial (the only prospective, double-blind, randomized clinical trial assessing the effect of proton pumpinhibitors on clopidogrel treatment), there was no differencein clinical events ("hard" end points) between clopidogrelplus omeprazole and clopidogrel alone.
38. Diener HC, Cunha L, Forbes C, et al.: EuropeanStroke Prevention Study. 2. Dipyridamole andacetylsalicylic acid in the secondary prevention ofstroke. J Neurol Sci 1996, 143:1-13.
39. Olsen TS, Langhorne P, Diener HC, et al.: EuropeanStroke Initiative Recommendations for StrokeManagement-update 2003. Cerebrovasc Dis 2003, 16:311-337.
40. Halkes PH, van Gijn J, Kappelle LJ, et al.: Mediumintensity oral anticoagulants versus aspirin aftercerebral ischaemia of arterial origin (ESPRIT): Arandomised controlled trial. Lancet Neurol 2007, 6:115-124.This international multicenter trial randomly assignedpatients who had a transient ischemic attack or minor strokeof presumed arterial origin within the previous 6 months toreceive anticoagulants (target INR range, 2.0-3.0; n=536) oraspirin (30-325 mg/d; n=532). The results showed thatanticoagulants are not more effective than aspirin for secondaryprevention after transient ischemic attack or minorstroke of arterial origin.
41. EAFT (European Atrial Fibrillation Trial) StudyGroup: Secondary prevention in non-rheumaticatrial fibrillation after transient ischaemic attack orminor stroke. Lancet 1993, 342:1255-1262.
42. Visser CA, Kan G, Meltzer RS, et al.: Long-term follow-up of left ventricular thrombus after acutemyocardial infarction. A two-dimensional echocardiographicstudy in 96 patients. Chest 1984, 86:532-536.
43. Mant J, Hobbs FD, Fletcher K, et al.: Warfarin versusaspirin for stroke prevention in an elderly communitypopulation with atrial fibrillation (the BirminghamAtrial Fibrillation Treatment of the AgedStudy, BAFTA): A randomised controlled trial. Lancet2007, 370:493-503.This trial with elderly AF patients at risk for stroke supportsthe use of anticoagulation therapy for people olderthan 75 years who have AF, unless there are contraindicationsor the patient decides the benefits are not worththe inconvenience.
44. Flaker GC, Gruber M, Connolly SJ, et al.: Risks andbenefits of combining aspirin with anticoagulanttherapy in patients with atrial fibrillation: An exploratoryanalysis of stroke prevention using anoral thrombin inhibitor in atrial fibrillation(SPORTIF) trials. Am Heart J 2006, 152:967-973.
45. Dressler FA, Craig WR, Castello R, Labovitz AJ: Mobileaortic atheroma and systemic emboli: efficacyof anticoagulation and influence of plaque morphologyon recurrent stroke. J Am Coll Cardiol 1998, 31:134-138.
46. The National Institute of Neurological Disorders andStroke rt-PA Stroke Study Group: Tissue plasminogenactivator for acute ischemic stroke. N Engl J Med1995, 333:1581-1587.
47. Wahlgren N, Ahmed N, Davalos A, et al.: Thrombolysiswith alteplase 3-4.5 h after acute ischaemicstroke (SITS-ISTR): An observational study. Lancet2008, 372:1303-1309.
48. Hacke W, Kaste M, Fieschi C, et al.: Intravenousthrombolysis with recombinant tissue plasminogenactivator for acute hemispheric stroke. TheEuropean Cooperative Acute Stroke Study (ECASS).JAMA 1995, 274:1017-1025.
49. Hacke W, Kaste M, Fieschi C, et al.: Randomiseddouble-blind placebo-controlled trial of thrombolytictherapy with intravenous alteplase in acuteischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators.Lancet 1998, 352:1245-1251.
50. Hacke W, Kaste M, Bluhmki E, et al.: Thrombolysiswith alteplase 3 to 4.5 hours after acute ischemicstroke. N Engl J Med 2008, 359:1317-1329.This is one of the most important articles published on thethrombolytic treatment of stroke. It shows that comparedwith placebo, IV alteplase administered between 3 and 4.5hours after the onset of symptoms significantly improvedclinical outcomes in patients with acute ischemic stroke.
51. Alexandrov AV, Molina CA, Grotta JC, et al.: Ultrasound-enhanced systemic thrombolysis for acuteischemic stroke. N Engl J Med 2004, 351:2170-2178.
52. Molina CA, Ribo M, Rubiera M, et al.: Microbubbleadministration accelerates clot lysis during continuous2-MHz ultrasound monitoring in strokepatients treated with intravenous tissue plasminogenactivator. Stroke 2006, 37:425-429.
53. Singh BN, Connolly SJ, Crijns HJ, et al.: Dronedaronefor maintenance of sinus rhythm in atrialfibrillation or flutter. N Engl J Med 2007, 357:987-999.Singh et al. confirm dronedarone's efficacy in maintainingsinus rhythm after AF, as well as its lack of deleterious effectson the thyroid gland.
54. Hohnloser SH, Crijns HJ, van Eickels M, et al.: Effectof dronedarone on cardiovascular events in atrialfibrillation. N Engl J Med 2009, 360:668-678.Dronedarone was the first antiarrhythmic treatment to reducemortality and CV hospitalizations in a rigorous clinicaltrial, namely a study with 4628 AF patients with an additionalrisk factor.
55. Connolly SJ, Crijns HJ, Torp-Pedersen C, et al.: Analysisof stroke in ATHENA: A placebo-controlled, double-blind, parallel-arm trial to assess the efficacyof dronedarone 400 mg BID for the prevention ofcardiovascular hospitalization or death from anycause in patients with atrial fibrillation/atrial flutter.Circulation 2009, 120:1174-1180.In this post hoc analysis of the ATHENA trial, an unexpectedreduction in stroke was observed in patients with AF whowere randomly assigned to receive dronedarone. Morestudies must be performed to ascertain this promising effectand to elucidate the pathophysiologic mechanism involved.
56. Kober L, Torp-Pedersen C, McMurray JJ, et al.: Increasedmortality after dronedarone therapy for severeheart failure. N Engl JMed 2008, 358:2678-2687.In patients with severe heart failure (New York Heart Associationclass III-IV) and left ventricular systolic dysfunction(ejection fraction <35%), treatment with dronedarone wasassociated with increased early mortality related to theworsening of heart failure.
57. Endarterectomy for moderate symptomatic carotidstenosis: interim results from the MRC EuropeanCarotid Surgery Trial. Lancet 1996, 347:1591-1593.
58. Nademanee K, Schwab MC, Kosar EM, et al.: Clinicaloutcomes of catheter substrate ablation for highriskpatients with atrial fibrillation. J Am CollCardiol 2008, 51:843-849.In a long-term follow-up of patients who underwent AFsubstrate ablation, sinus rhythm was the most importantindependent favorable parameter for survival. The annualstroke rate was only 0.4% in patients who discontinuedwarfarin in sinus rhythm after ablation, compared with 2%in those who continued warfarin treatment (P=0.004).
59. Themistoclakis S, Corrado A, Marchlinski FE, et al.:The risk of thromboembolism and need for oralanticoagulation after successful atrial fibrillationablation. J Am Coll Cardiol 2010, 55:735-743.In this nonrandomized study, the risk-benefit ratio favoredthe suspension of warfarin after successful AF ablation (andcareful monitoring of this success), even in patients atmoderate to high risk for systemic embolism.
60. Bonow RO, Carabello BA, Chatterjee K, et al.: 2006Writing Committee Members; American College ofCardiology/American Heart Association Task Force:2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management ofpatients with valvular heart disease: A report of theAmerican College of Cardiology/American HeartAssociation Task Force on Practice Guidelines(Writing Committee to Revise the 1998 Guidelinesfor the Management of Patients With Valvular HeartDisease): endorsed by the Society of CardiovascularAnesthesiologists, Society for Cardiovascular Angiographyand Interventions, and Society of ThoracicSurgeons. Circulation 2008, 118:e523-e661.This is the latest update of the American College of Cardiology/American Heart Association guidelines for the managementof patients with valvular heart disease.
61. Block PC, Burstein S, Casale PN, et al.: Percutaneousleft atrial appendage occlusion for patients in atrialfibrillation suboptimal for warfarin therapy: 5-yearresults of the PLAATO (Percutaneous Left AtrialAppendage Transcatheter Occlusion) Study. JACCCardiovasc Interv 2009, 2:594-600.In this 5-year follow-up of 64 patients receiving the PLAATOdevice and no subsequent OAC therapy, the annualizedstroke/transient ischemic attack rate was 3.8% per year, muchlower than that predicted by the CHADS2 scoring system.
62. Holmes DR, Reddy VY, Turi ZG, et al.: Percutaneousclosure of the left atrial appendage versus warfarintherapy for prevention of stroke in patients withatrial fibrillation: A randomised non-inferioritytrial. Lancet 2009, 374:534-542.This landmark study in prevention of AF stroke risk randomlyassigned 707 eligible patients to receive conventional OAC orto undergo percutaneous closure of the LAA with the Watchmanoccluder and to subsequently discontinue warfarin. TheWatchman device implantation strategy was noninferior towarfarin therapy. Although there were some procedural complications(5% of patients with pericardial effusion requireddrainage), the risk of hemorrhagic stroke was lower and the riskof ischemic stroke no different with the LAA occluder.
63. Connolly SJ, Ezekowitz MD, Yusuf S, et al.: Dabigatranversus warfarin in patients with atrial fibrillation.N Engl J Med 2009, 361:1139-1151.This revolutionary clinical trial showed that for preventingemboli in AF patients, dabigatran, 110 mg, was as effective aswarfarin in stroke prevention, but with fewer major hemorrhages, whereas dabigatran, 150 mg, was more effective thanwarfarin in stroke prevention, with a similar rate of majorhemorrhage.
64. Garcia D, Libby E, Crowther MA: The new oralanticoagulants. Blood 2010, 115:15-20.This is an excellent, up-to-date review of the new oral anticoagulants, especially factor Xa inhibitors.
65. Chamorro A: TP receptor antagonism: A new conceptin atherothrombosis and stroke prevention.Cerebrovasc Dis 2009, 27(Suppl 3):20-27.This is a nice overview of the pathophysiology and pharmacologicinhibition of TP receptors.
66. Viles-Gonzalez JF, Fuster V, Corti R, et al.: Atherosclerosisregression and TP receptor inhibition:effect of S18886 on plaque size and composition-a magnetic resonance imaging study. Eur Heart J2005, 26:1557-1561.
67. Huang Y, Cheng Y, Wu J, et al.: Cilostazol as an alternative to aspirin after ischaemic stroke: a randomised, double-blind, pilot study. Lancet Neurol 2008, 7:494-499. In this study of 720Chinese patientswith ischemic stroke, there was no significant difference in the rate of stroke recurrence between patients who were randomly assigned to receive aspirin and those assigned to receive cilostazol, a selective phosphodiesterase type 3 inhibitor with antiaggregant effects. The lower rates of ischemic and hemorrhagic stroke in the cilostazol group suggest that cilostazolmight be amore effective and safer alternative to aspirin for Chinese patients with ischemic stroke.
68. Fergusson GG, Eliasziw M, Bar HW, et al.: The NorthAmerican Symptomatic Carotid EndarterectomyTrial: surgical results in 1415 patients. Stroke 1999, 30:1751-1758.
69. European Carotid Surgery Trialists' CollaborativeGroup: MRC European Carotid Surgery Trial: interimresults for symptomatic patients with severe(70-99%) or with mild (0-29%) carotid stenosis.Lancet 1991, 337:1235-1243.
70. Asymptomatic Carotid Atherosclerosis Study Group:Study design for randomized prospective trial ofcarotid endarterectomy for asymptomatic atherosclerosis.Stroke 1989, 20:844-849.
71. Halliday AW, Thomas D, Mansfield A, et al.: TheAsymptomatic Carotid Surgery Trial (ACST). Rationaleand design. Steering Committee. Eur J VascSurg 1994, 8:703-710.
72. Iyer SS, White CJ, Hopkins LN, et al.: Carotid arteryrevascularization in high-surgical-risk patients usingthe Carotid WALLSTENT and FilterWire EX/EZ:1-year outcomes in the BEACH Pivotal Group. J AmColl Cardiol 2008, 51:427-434.
73. Registry Study to Evaluate the NeuroShield Bare WireCerebral Protection System and X-Act Stent inPatients at High Risk for Carotid Endarterectomy. Available at http://www.strokecenter.org/trials.
74. Endarterectomy Versus Angioplasty in Patients WithSevere Symptomatic Carotid Stenosis. Available athttp://www.strokecenter.org/trials.
75. Gray WA, Hopkins LN, Yadav S, et al.: Protectedcarotid stenting in high-surgical-risk patients: theARCHeR results. J Vasc Surg 2006, 44(2):258-268.
76. Gray WA, Yadav JS, Verta P, et al.: The CAPTUREregistry: predictors of outcomes in carotid arterystenting with embolic protection for high surgicalrisk patients in the early post-approval setting.Catheter Cardiovasc Interv 2007, 70:1025-1033.
77. Safian RD, Bacharach JM, Ansel GM, et al.: Carotidstenting with a new system for distal embolic protectionand stenting in high-risk patients: the carotidrevascularization with ev3 arterial technologyevolution (CREATE) feasibility trial. Catheter CardiovascInterv 2004, 63:1-6.
78. Multicenter Registry to Assess the Safety and Efficacyof the MO.MA Cerebral Protection Device DuringCarotid Stenting. Available at htpp://www.strokecenter.org/trials.
79. Coppi G, Moratto R, Silingardi R, et al.: Proximalflow blockage cerebral protection during carotidstenting: results from a multicenter Italian registry.J Cardiovasc Surg (Torino) 2005, 46:219-227.
80. Katzen BT, Criado FJ, Ramee SR, et al.: Carotid arterystenting with emboli protection surveillance study:thirty-day results of the CASES-PMS study. CatheterCardiovasc Interv 2007, 70:316-323.
81. Hopkins LN, Myla S, Grube E, et al.: Carotid arteryrevascularization in high risk patients with theNexstent and the Filterwire EX/EZ: 1 year results ofthe CABERNET trial. Catheter Cardiovasc Interv 2008, 71:950-960.
82. Naylor AR, Bolia A, Abbott RJ, et al.: Randomizedstudy of carotid angioplasty and stenting versuscarotid endarterectomy: A stopped trial. J Vasc Surg1998, 28:326-334.
83. CAVATAS Investigators: Endovascular versus surgicaltreatment in patients with carotid stenosis inthe Carotid and Vertebral Artery Transluminal AngioplastyStudy (CAVATAS): A randomised trial.Lancet 2001, 357:1729-1737.
84. Alberts MJ: Results of a multicenter prospectiverandomized trial of carotid artery stenting vs carotidendarterectomy. Stroke 2001, 32:325.
85. Brooks WH, McClure RR, Jones MR, et al.: Carotidangioplasty and stenting versus carotid endarterectomy:randomized trial in a community hospital.J Am Coll Cardiol 2001, 38:1589-1595.
86. Brooks WH, McClure RR, Jones MR, et al.: Carotidangioplasty and stenting versus carotid endarterectomyfor treatment of asymptomatic carotid stenosis: A randomized trial in a community hospital.Neurosurgery 2004, 54:318-325.
87. CaRESS Steering Committee: Carotid RevascularizationUsing Endarterectomy or Stenting Systems(CaRESS) phase I clinical trial: 1-year results. J VascSurg 2005, 42:213-219.
88. Yadav JS, Wholey MH, Kuntz RE, et al.: Protectedcarotid-artery stenting versus endarterectomy inhigh-risk patients. N Engl J Med 2004, 351:1493-1501.
89. SPACE Collaborative Group, Ringleb PA, Allenberg J, Brückmann H, et al.: 30 day results from the SPACEtrial of stent-protected angioplasty versus carotidendarterectomy in symptomatic patients: A randomizednon-inferiority trial. Lancet 2006, 368:1239-1247.
90. Mas JL, Chatellier G, Beyssen B, et al.: Endarterectomyversus stenting in patients with symptomaticsevere carotid stenosis. N Engl J Med 2006, 355:1660-1671.
91. International Carotid Stenting Study Investigators:Carotid artery stenting compared with endarterectomyin patients with symptomatic carotid stenosis(International Carotid Stenting Study): An interimanalysis of a randomized control trial. Lancet 2010, 375:985-997.
92. Brott TG, Roubin G, Howard G, et al.: The RandomizedCarotid Revascularization Endarterectomyvs Stenting Trial (CREST): primary results [abstract197]. Presented at the 2010 American Stroke AssociationInternational Stroke Conference. San Antonio, TX; February 26, 2010.