Doctor Information

Information for Doctors

Overview of the Study ACST-2 Introductory Slide Presentation

Asymptomatic carotid stenosis (with no symptoms for 6 months, and no previous procedures performed on it).
Medical treatment (e.g. aspirin,statin) already commenced.
Recovered from necessary coronary procedures (e.g. coronary artery bypass).
Thought to need procedural treatment now with either carotid endarterectomy (CEA) or carotid stenting (CAS).
MRA, CTA or other form of angiography show that CEA and CAS are both practicable.
Doctor is substantially uncertain whether CEA or CAS is better for the patient.

Discuss the study with the patient and provide the information leaflet and consent form with the ACST-2 doctors name on it for the patient to read.
If the patient is substantially uncertain between CEA and CAS, and willing to participate in ACST-2, the patient can give a witnessed signature on the consent form.
Consent requires the address of the patient (for annual follow-up letter) and address of their family doctor and two friends or relatives (to help ensure follow-up).

Complete at least part 1 of the randomisation form before telephoning as these details are needed during the telephone randomisation.
Call the randomisation service on +44 (0)1865765615 to obtain the treatment allocation (CEA/CAS) and a 6-digit patient ID.
Inform the patient of the allocation and plan for the allocated procedure (CEA/CAS) to be done as soon as possible.

A collaborator whose track record has been approved performs the procedure using their normal technique and approved materials.
Before discharge a one month follow-up is arranged for examination by a neurologist or stroke physician, and duplex ultrasonography of the carotids.
Complete one month post-procedural form. Annual follow-up is then by letter to the patient from the central ACST-2 office.