J Neurol Sci. 1995 Mar;129(1):76-7. doi: 10.1016/0022-510x(95)00010-y.
On September 28, 1994, the investigators of the Asymptomatic Carotid Atherosclerosis Study (ACAS) reported the interim results of a randomized controlled clinical trial of carotid endarterectomy in patients who have asymptomatic carotid stenosis of greater than 60% reduction in diameter. In addition to aspirin and aggressive management of modifiable risk factors, one-half of the patients were randomly assigned to receive surgery after angiographic confirmation of the lesion. Carotid endarterectomy is beneficial with a statistically significant absolute reduction of 5.8% in the risk of the primary end point of stroke within 5 years and a relative risk reduction of 55%. As a consequence of the trial reaching statistical significance in favor of endarterectomy, and on the recommendation of the study's data monitoring committee, physicians participating in the study were immediately notified and advised to reevaluate patients who did not receive surgery. It is important to note that the success of the operation is dependent on medical centers and surgeons who have a documented perioperative morbidity and mortality of less than 3%, careful selection of patients, and postoperative management of modifiable risk factors.
1994年9月28日，无症状性颈动脉粥样硬化研究（ACAS）的研究人员报告了一项针对直径缩小超过60%的无症状性颈动脉狭窄患者进行颈动脉内膜切除术的随机对照临床试验的中期结果。除了使用阿司匹林和积极控制可改变的危险因素外，一半的患者在血管造影确认病变后被随机分配接受手术。颈动脉内膜切除术是有益的，在5年内主要终点事件中风风险的绝对降低率有统计学意义，为5.8%，相对风险降低率为55%。由于该试验在统计学上支持内膜切除术，并且根据研究数据监测委员会的建议，参与研究的医生立即得到通知，并被建议重新评估未接受手术的患者。需要注意的是，手术的成功取决于围手术期发病率和死亡率记录低于3%的医疗中心和外科医生、对患者的仔细筛选以及对可改变危险因素的术后管理。
