Transfemoral carotid artery stent placement for asymptomatic extracranial carotid stenosis
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 3 systematic reviews, 2 randomised controlled trials, 1 prospective cohort study, 2 retrospective cohort studies and 1 retrospective international administrative dataset. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in table 5 of the overview.
3.2 The professional experts and the committee considered the key efficacy outcome to be: stroke prevention.
3.3 The professional experts and the committee considered the key safety outcomes to be: stroke, infection, haemorrhage, restenosis.
3.4 One commentary from a person who had this procedure was discussed by the committee.
Committee comments
3.5 The committee was informed that simulation training for the procedure is available.
3.6 The committee noted that there are several ongoing clinical trials.
3.7 The committee noted that technical aspects of the procedure, such as stents and cerebral protection devices, have changed over time.
3.8 The committee noted that although there is new information, there is still uncertainty about the role of this intervention in people with asymptomatic carotid stenosis.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
May 2023
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