Eversion versus conventional carotid endarterectomy for preventing stroke.


BACKGROUND:Carotid endarterectomy is conventionally undertaken by a longitudinal arteriotomy. Eversion carotid endarterectomy (CEA), which employs a transverse arteriotomy and reimplantation of the carotid artery, is reported to be associated with low perioperative stroke and restenosis rates but an increased risk of complications associated with a distal intimal flap. OBJECTIVES:The objective of this review was to determine whether eversion CEA was safe and more effective than conventional CEA. The null-hypothesis was that there was no difference between the eversion and the conventional CEA techniques (performed either with primary closure or patch angioplasty). SEARCH STRATEGY:The reviewers searched MEDLINE and the Cochrane Stroke Group Trials Register (last searched: December 1999), and hand searched eight surgical journals and conference proceedings. Researchers were contacted to identify additional published and unpublished studies. SELECTION CRITERIA:All randomised trials comparing eversion to conventional techniques in patients undergoing carotid endarterectomy were examined in this review. Outcomes were stroke and death, carotid restenosis/occlusion and local complications. DATA COLLECTION AND ANALYSIS:Data were extracted independently by two reviewers to assess eligibility and describe trial characteristics, and by one reviewer for the meta-analyses. Discrepancies were resolved by discussion. When possible, unpublished data were obtained from investigators. MAIN RESULTS:Five trials were included for a total of 2465 patients and 2590 arteries. Three trials included bilateral carotid endarterectomies. In one trial, arteries rather than patients were randomised so that it was not clear how many patients had been randomised in each group, therefore, information on the risk of stroke and death from this study were considered in a separate analysis. There were no significant differences in the rate of perioperative stroke and/or death (1.7% vs 2.6%, odds ratio [OR] 0.44, 95% confidence interval [CI] 0.10-1.82) and stroke during follow-up (1.4% vs 1.7%, OR: 0.84, 95% CI: 0.43-1.64) between eversion and conventional CEA techniques. Eversion CEA was associated with a significantly lower rate of restenosis >50% during follow-up (2.5% vs 5.2%, OR: 0.48, 95% CI: 0.32 -0.72). However, there was no evidence that the eversion technique for CEA was associated with a lower rate of neurological events when compared to conventional CEA. There were no statistically significant differences in local complications between the eversion and conventional group. No data were available to define the cost-benefit of eversion CEA technique. REVIEWER'S CONCLUSIONS:Eversion CEA may be associated with low risk of arterial occlusion and restenosis. However, numbers are too small to definitively assess benefits or harms. Reduced restenosis rates did not appear to be associated with clinical benefit in terms of reduced stroke risk, either perioperatively or later. Until further evidence is available, the choice of the CEA technique should depend on the experience and familiarity of the individual surgeon.


Cao PG,de Rango P,Zannetti S,Giordano G,Ricci S,Celani MG





Has Abstract


2001-01-01 00:00:00










  • Early versus late chest radiotherapy for limited stage small cell lung cancer.

    abstract:BACKGROUND:It is standard clinical practice to combine chemotherapy and chest radiotherapy in treating patients with limited-stage small cell lung cancer. However, the best way to integrate both modalities is unclear. OBJECTIVES:To establish the most effective way of combining chest radiotherapy with chemotherapy for ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Pijls-Johannesma MC,De Ruysscher D,Lambin P,Rutten I,Vansteenkiste JF

    更新日期:2005-01-25 00:00:00

  • Post-operative radiotherapy for ductal carcinoma in situ of the breast.

    abstract:BACKGROUND:The addition of radiotherapy (RT) following breast conserving surgery (BCS) was first shown to reduce the risk of ipsilateral recurrence in the treatment of invasive breast cancer. Ductal carcinoma in situ (DCIS) is a pre-invasive lesion. Recurrence of ipsilateral disease following BCS can be either DCIS or ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Goodwin A,Parker S,Ghersi D,Wilcken N

    更新日期:2009-07-08 00:00:00

  • Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months.

    abstract:BACKGROUND:Pneumonia is a leading cause of morbidity and mortality in children younger than five years of age. Most deaths occur during infancy and in low-income countries. Daily zinc supplements have been reported to prevent acute lower respiratory tract infection (LRTI) and reduce child mortality. This is an update o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Lassi ZS,Moin A,Bhutta ZA

    更新日期:2016-12-04 00:00:00

  • Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable).

    abstract:BACKGROUND:In general, surgery is believed to offer the best prospects for cure for early stage non-small cell lung cancer (NSCLC). In spite of the intention to consider all patients with stage I-II disease for surgery, there are those who, although technically operable, either refuse surgery or are considered inoperab...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Rowell NP,Williams CJ

    更新日期:2001-01-01 00:00:00

  • Bile acids for primary sclerosing cholangitis.

    abstract:BACKGROUND:Bile acids have been used for treating primary sclerosing cholangitis, but their beneficial and harmful effects remain unclear. OBJECTIVES:To assess the beneficial and harmful effects of bile acids for patients with primary sclerosing cholangitis. SEARCH STRATEGY:We searched The Cochrane Hepato-Biliary Gro...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Chen W,Gluud C

    更新日期:2003-01-01 00:00:00

  • Slow-release oral morphine as maintenance therapy for opioid dependence.

    abstract:BACKGROUND:Opioid substitution treatments are effective in retaining people in treatment and suppressing heroin use. An open question remains whether slow-release oral morphine (SROM) could represent a possible alternative for opioid-dependent people who respond poorly to other available maintenance treatments. OBJECT...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Ferri M,Minozzi S,Bo A,Amato L

    更新日期:2013-06-05 00:00:00

  • Mefloquine for preventing malaria during travel to endemic areas.

    abstract:BACKGROUND:Mefloquine is one of four antimalarial agents commonly recommended for preventing malaria in travellers to malaria-endemic areas. Despite its high efficacy, there is controversy about its psychological side effects. OBJECTIVES:To summarize the efficacy and safety of mefloquine used as prophylaxis for malari...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Tickell-Painter M,Maayan N,Saunders R,Pace C,Sinclair D

    更新日期:2017-10-30 00:00:00

  • Topical umbilical cord care at birth.

    abstract:BACKGROUND:Umbilical cord infection caused many neonatal deaths before aseptic techniques were used. OBJECTIVES:The objective of this review was to assess the effects of topical cord care in preventing cord infection, illness and death. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials re...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Zupan J,Garner P

    更新日期:2000-01-01 00:00:00

  • Electroconvulsive therapy for schizophrenia.

    abstract:BACKGROUND:Electroconvulsive therapy (ECT) involves the induction of a seizure (fit) for therapeutic purposes by the administration of a variable frequency electrical stimulus shock via electrodes applied to the scalp. The effects of its use in people with schizophrenia are unclear. OBJECTIVES:To determine whether ele...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Tharyan P,Adams CE

    更新日期:2002-01-01 00:00:00

  • Anticoagulation for the initial treatment of venous thromboembolism in patients with cancer.

    abstract:BACKGROUND:Compared to patients without cancer, patients with cancer who receive anticoagulant treatment for venous thromboembolism are more likely to develop recurrent venous thromboembolism (VTE). OBJECTIVES:To compare the efficacy and safety of three types of parenteral anticoagulants for the initial treatment of V...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Akl EA,Vasireddi SR,Gunukula S,Barba M,Sperati F,Terrenato I,Muti P,Schünemann H

    更新日期:2011-06-15 00:00:00

  • Adenosine versus intravenous calcium channel antagonists for the treatment of supraventricular tachycardia in adults.

    abstract:BACKGROUND:Patients with paroxysmal supraventricular tachycardia frequently present to the Emergency Department. Where vagal manoeuvres fail, the two most commonly used drugs are adenosine and calcium channel antagonists. Both are known to be effective but both have a significant side-effect profile. OBJECTIVES:To exa...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Holdgate A,Foo A

    更新日期:2006-10-18 00:00:00

  • Intravenous oxytocin alone for cervical ripening and induction of labour.

    abstract:BACKGROUND:Oxytocin is the commonest induction agent used worldwide. It has been used alone, in combination with amniotomy or following cervical ripening with other pharmacological or non-pharmacological methods. Prior to the introduction of prostaglandin agents oxytocin was used as a cervical ripening agent as well. I...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Kelly AJ,Tan B

    更新日期:2001-01-01 00:00:00

  • Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.

    abstract:BACKGROUND:Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (bi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Biesty LM,Egan AM,Dunne F,Dempsey E,Meskell P,Smith V,Ni Bhuinneain GM,Devane D

    更新日期:2018-01-05 00:00:00

  • Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular diseases.

    abstract:BACKGROUND:Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death and disability worldwide, yet ASCVD risk factor control and secondary prevention rates remain low. A fixed-dose combination of blood pressure- and cholesterol-lowering and antiplatelet treatments into a single pill, or polypill, has...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Bahiru E,de Cates AN,Farr MR,Jarvis MC,Palla M,Rees K,Ebrahim S,Huffman MD

    更新日期:2017-03-06 00:00:00

  • Fluid and pharmacological agents for adhesion prevention after gynaecological surgery.

    abstract:BACKGROUND:Adhesions are fibrin bands that are a common consequence of gynaecological surgery. They are caused by various conditions including pelvic inflammatory disease and endometriosis. Adhesions are associated with considerable co-morbidity, including pelvic pain, subfertility and small bowel obstruction. Patients...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Ahmad G,Mackie FL,Iles DA,O'Flynn H,Dias S,Metwally M,Watson A

    更新日期:2014-07-09 00:00:00

  • Fluid therapy for acute bacterial meningitis.

    abstract:BACKGROUND:Acute bacterial meningitis remains a disease with high mortality and morbidity rates. However, with prompt and adequate antimicrobial and supportive treatment, the chances for survival have improved, especially in infants and children. Careful management of fluid and electrolyte balance is an important suppo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Maconochie I,Baumer H,Stewart ME

    更新日期:2008-01-23 00:00:00

  • Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses.

    abstract:BACKGROUND:Chronic excessive alcohol consumption may lead to dependence, and to alcohol withdrawal syndrome (AWS) in case of abrupt drinking cessation. Gamma-hydroxybutyric acid (GHB) can prevent and suppress withdrawal symptoms, and improve the medium-term abstinence rate. A clear balance between effectiveness and har...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Leone MA,Vigna-Taglianti F,Avanzi G,Brambilla R,Faggiano F

    更新日期:2010-02-17 00:00:00

  • Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

    abstract:BACKGROUND:People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Stroke services need to be configured to maximise the adoption of evidence-based strategies for secondary stroke prevention. Smoking-related interventions were examined in a separate...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Bridgwood B,Lager KE,Mistri AK,Khunti K,Wilson AD,Modi P

    更新日期:2018-05-07 00:00:00

  • Intra-uterine insemination for unexplained subfertility.

    abstract:BACKGROUND:Intra-uterine insemination (IUI) is a widely used fertility treatment for couples with unexplained subfertility. Although IUI is less invasive and less expensive thAppendixan in vitro fertilisation (IVF), the safety of IUI in combination with ovarian hyperstimulation (OH) is debated. The main concern about I...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Veltman-Verhulst SM,Hughes E,Ayeleke RO,Cohlen BJ

    更新日期:2016-02-19 00:00:00

  • Vitamin K supplementation for cystic fibrosis.

    abstract:BACKGROUND:Cystic fibrosis is a genetic disorder which can lead to multiorgan dysfunction. Malabsorption of fat and fat-soluble vitamins (A, D, E, K) may occur and can cause subclinical deficiencies of some of these vitamins. Vitamin K is known to play an important role in both blood coagulation and bone formation. Sup...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Jagannath VA,Fedorowicz Z,Thaker V,Chang AB

    更新日期:2011-01-19 00:00:00

  • Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health.

    abstract:BACKGROUND:Frequent consumption of excess amounts of sugar-sweetened beverages (SSB) is a risk factor for obesity, type 2 diabetes, cardiovascular disease and dental caries. Environmental interventions, i.e. interventions that alter the physical or social environment in which individuals make beverage choices, have bee...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: von Philipsborn P,Stratil JM,Burns J,Busert LK,Pfadenhauer LM,Polus S,Holzapfel C,Hauner H,Rehfuess E

    更新日期:2019-06-12 00:00:00

  • Integration of HIV/AIDS services with maternal, neonatal and child health, nutrition, and family planning services.

    abstract:BACKGROUND:The integration of HIV/AIDS and maternal, neonatal, child health and nutrition services (MNCHN), including family planning (FP) is recognized as a key strategy to reduce maternal and child mortality and control the HIV/AIDS epidemic. However, limited evidence exists on the effectiveness of service integratio...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Lindegren ML,Kennedy CE,Bain-Brickley D,Azman H,Creanga AA,Butler LM,Spaulding AB,Horvath T,Kennedy GE

    更新日期:2012-09-12 00:00:00

  • Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants.

    abstract:BACKGROUND:A patent ductus arteriosus (PDA) complicates the clinical course of preterm infants, increasing their risks of developing chronic lung disease (CLD), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH). Indomethacin is used as standard therapy to close a PDA, but is associated with reduced...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Ohlsson A,Walia R,Shah S

    更新日期:2008-01-23 00:00:00

  • Methotrexate for maintenance of remission in Crohn's disease.

    abstract:BACKGROUND:Safe and effective long-term treatments that reduce the need for corticosteroids are needed for Crohn's disease. Although purine antimetabolites are moderately effective for maintenance of remission patients often relapse despite treatment with these agents. Methotrexate may provide a safe and effective alte...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Patel V,Macdonald JK,McDonald JW,Chande N

    更新日期:2009-10-07 00:00:00

  • Print-based self-help interventions for smoking cessation.

    abstract:BACKGROUND:Many smokers give up smoking on their own, but materials that provide a structured programme for smokers to follow may increase the number who quit successfully. OBJECTIVES:The aims of this review were to determine the effectiveness of different forms of print-based self-help materials that provide a struct...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Livingstone-Banks J,Ordóñez-Mena JM,Hartmann-Boyce J

    更新日期:2019-01-09 00:00:00

  • Antidepressants for depression in people with physical illness.

    abstract:OBJECTIVES:To determine whether antidepressants are clinically effective and acceptable for the treatment of depression in people who also have a physical illness. SEARCH STRATEGY:Medline, Cochrane Library Trials Register and Cochrane Depression and Neurosis Group Trials Register were all systematically searched, supp...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Gill D,Hatcher S

    更新日期:2000-01-01 00:00:00

  • Screening programmes for the early detection and prevention of oral cancer.

    abstract:BACKGROUND:Oral cancer is an important global healthcare problem, its incidence is increasing and late-stage presentation is common. Screening programmes have been introduced for a number of major cancers and have proved effective in their early detection. Given the high morbidity and mortality rates associated with or...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Brocklehurst P,Kujan O,Glenny AM,Oliver R,Sloan P,Ogden G,Shepherd S

    更新日期:2010-11-10 00:00:00

  • Beta2-agonists for acute bronchitis.

    abstract:BACKGROUND:There are no clearly effective treatments for the cough of acute bronchitis, and beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction contributing to the symptoms. OBJECTIVES:To determine whether beta2-agonists improve symptoms of acu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Smucny J,Becker L,Glazier R

    更新日期:2006-10-18 00:00:00

  • Crisis intervention for people with severe mental illnesses.

    abstract:BACKGROUND:A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis-intervention models of care were developed as a possible solution. OBJECTIVES:To review the effects of cr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Murphy SM,Irving CB,Adams CE,Waqar M

    更新日期:2015-12-03 00:00:00

  • Anti-IgE therapy for allergic bronchopulmonary aspergillosis in people with cystic fibrosis.

    abstract:BACKGROUND:Cystic fibrosis is an autosomal recessive multisystem disorder with an approximate prevalence of 1 in 3500 live births. Allergic bronchopulmonary aspergillosis is a lung disease caused by aspergillus-induced hypersensitivity with a prevalence of 2% to 15% in people with cystic fibrosis. The mainstay of treat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Jat KR,Walia DK,Khairwa A

    更新日期:2013-09-17 00:00:00