Veterans Affairs Cooperative Asymptomatic Study 1983-1991; published 1993 in NEJM. Randomized 444 asymptomatic men with 50-99% stenosis CEA/ASA or ASA.

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Presentation transcript:

Veterans Affairs Cooperative Asymptomatic Study ; published 1993 in NEJM. Randomized 444 asymptomatic men with 50-99% stenosis CEA/ASA or ASA. Endpoints: TIA, stroke or death After a mean of 48 months the incidence of all ipsilateral neurologic events % surgery vs. 20.6% medicine (p<0.001). Ipsilateral stroke alone % surgery vs. 9.4% medicine. Stroke and death % vs. 44.2%. Both ns. Perioperative stroke - 2.4%; Death - 1.9% Criticized for small numbers and for counting TIA as outcome equivalent to stroke.