Journal article
Investigating the mechanisms of perioperative ischemic stroke in the Carotid Occlusion Surgery Study
Journal of neurosurgery, Vol.119(4), pp.988-995
10/2013
DOI: 10.3171/2013.6.JNS13312
PMID: 23909253
Abstract
The Carotid Occlusion Surgery Study (COSS) was a large, prospective clinical trial that examined whether superficial temporal artery-middle cerebral artery (STA-MCA) bypass, in addition to best medical therapy, reduced the risk of ipsilateral ischemic stroke in patients with carotid artery occlusion and hemodynamic cerebral ischemia. Despite improved cerebral hemodynamics and excellent bypass graft patency rates, COSS failed to show a benefit for the surgical group with respect to ipsilateral stroke recurrence at 2 years after treatment. This was due to a lower than expected rate of recurrent ipsilateral stroke in the medically treated group and a high rate of perioperative ipsilateral strokes in the surgical group. Critics of the trial have cited surgeon inexperience and technical difficulties related to the performance of the bypass graft as a leading cause of failure of the trial.
Details
- Title: Subtitle
- Investigating the mechanisms of perioperative ischemic stroke in the Carotid Occlusion Surgery Study
- Creators
- Matthew R Reynolds - Departments of Neurological SurgeryRobert L Grubb JrWilliam R ClarkeWilliam J PowersGregory J ZipfelHarold P Adams JrColin P Derdeyn
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.119(4), pp.988-995
- Publisher
- United States
- DOI
- 10.3171/2013.6.JNS13312
- PMID
- 23909253
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 10/2013
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020785802771
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