Clinical trial

Carotid Revascularization Versus Best Medical Treatment for Asymptomatic Carotid Stenosis: a Multicenter, Open, Randomized Controlled Trial in Chinese Population

Name
CRBMACS
Description
This is a multicenter, open, randomized controlled trial to evaluate the efficacy and safety of carotid artery stenting/carotid endarterectomy versus best medical treatment for asymptomatic carotid artery stenosis in Chinese population.
Trial arms
Trial start
2022-10-14
Estimated PCD
2025-12-01
Trial end
2025-12-01
Status
Recruiting
Treatment
Carotid Revascularization
Carotid Artery Stenting/Carotid Endarterectomy
Arms:
Carotid Revascularization
Medical Treatment
Aspirin 100mg/ day plus clopidogrel 75mg/ day for the first three months after enrollment or revascularization, aspirin 100mg/ day after three months, and the statin dose was adjusted according to blood lipids levels. Best medical treatment also includes risk factor control: good lifestyle, smoking cessation, weight control, regular exercise, SBP \< 140 mmHg, HDL \< 70 mg/dl (1.8mmol/L), and glycemic control. Patients with poor control of risk factors were dynamically adjusted during follow-up. In addition, patients undergoing CAS received dual antiplatelet therapy for at least 3 to 5 days before surgery, and patients undergoing CEA also received a preoperative oral antiplatelet drug (aspirin 100mg/ day, or clopidogrel 75mg/ day) for at least 3 days after enrollment.
Arms:
Carotid Revascularization, Medical Treatment
Size
1056
Primary endpoint
Any Periprocedural Stroke, Myocardial Infarction, or Death During1 month Peri-procedural Period, and Postprocedural Ipsilateral Stroke 1 to 12-months.
0 to 12 months
Eligibility criteria
Inclusion Criteria: 1. Age 40-80 years; 2. Carotid artery stenosis 50%-90% (ultrasound, CT, or DSA); 3. Asymptomatic carotid stenosis, that is, no transient ischemic attack, stroke, or other neurological symptoms in the past 6 months; 4. Patients who could complete 12 months of follow-up; 5. Patients who signed informed consent forms. Exclusion Criteria: 1. Patients who had a TIA, stroke, or other related neurological symptoms within the previous 6 months; 2. Patients with spontaneous intracerebral hemorrhage in the past 12 months; 3. Patients with large intracranial aneurysms (diameter\> 5mm),and cannot be treated in advance or contemporaneous; 4. Chronic total occlusion without obvious cerebral ischemia symptoms; 5. Patients with neurologic disorder that caused transient or permanent neurological deficits and can not be identified with transient ischemic attack or stroke; 6. Patients with severe dementia; 7. Common carotid artery opening lesion; 8. Severe intracranial stenosis in tandem; 9. Carotid artery dissection; 10. Carotid artery aneurysm; 11. Myocardial infarction occurred within 30 days; 12. It is known that two or more proximal or main coronary artery stenosis ≥70%, untreated or unable to recanalize; 13. Ejection fraction \<30% or New York Heart Association (NYHA) functional class III or higher;Unstable angina,ie angina at resting state and electrocardiogram changes; 14. Patients with cardiac emboli sources, such as left ventricular aneurysm, intraluminal filling defect, cardiomyopathy, aortic or mitral prosthetic heart valve, calcific aortic stenosis, infective endocarditis, mitral stenosis, atrial septal defect, atrial septal aneurysm, or left atrial myxoma; 15. Platelet count \<5×104/μL, INR\>1.5, Bleeding time \> 1 min, or heparin-related thrombocytopenia;Patients contraindicated to heparin and antiplatelet drugs; 16. Patients with coagulation dysfunction. 17. Poor control of diabetes, fasting blood glucose \>22mmol/L and ketone body \> +2; 18. Malignant tumor or respiratory insufficiency, life expectancy \< 5 years. 19. Insufficiency of vital organs: forced expiratory volume at one second \< 30% (predicted); dialysis-dependent renal failure; intolerance to anesthesia; 20. Currently waiting main organ transplants (ie heart, lung, liver, kidney), or are doing relevant evaluate; 21. Need to perform other general anesthesia surgery during the same period; 22. Pregnant or lactating women; 23. Those who participated in clinical trials of other drugs or medical devices before the inclusion did not reach the end of the time limit; 24. Investigators consider the patient inappropriate to participate in this clinical trial;
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['NA'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 1056, 'type': 'ESTIMATED'}}
Updated at
2023-01-31

1 organization

1 product

4 indications

Organization
Xuanwu Hospital