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Immediate versus delayed treatment for recently symptomatic carotid artery stenosis

Overview of attention for article published in Cochrane database of systematic reviews, September 2016
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (55th percentile)

Mentioned by

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4 tweeters
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1 Facebook page

Citations

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8 Dimensions

Readers on

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82 Mendeley
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Title
Immediate versus delayed treatment for recently symptomatic carotid artery stenosis
Published in
Cochrane database of systematic reviews, September 2016
DOI 10.1002/14651858.cd011401.pub2
Pubmed ID
Authors

Vladimir Vasconcelos, Nicolle Cassola, Edina MK da Silva, Jose CC Baptista-Silva

Abstract

The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis. We searched the Cochrane Stroke Group Trials Register in January 2016, the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, Issue 1), MEDLINE (1948 to 26 January 2016), EMBASE (1974 to 26 January 2016), LILACS (1982 to 26 January 2016), and trial registers (from inception to 26 January 2016). We also handsearched conference proceedings and journals, and searched reference lists. There were no language restrictions. We contacted colleagues and pharmaceutical companies to identify further studies and unpublished trials. All completed, truly randomized trials (RCT) that compared very early cerebral revascularization (within two days) with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis. We independently selected trials for inclusion according to the above criteria, assessed risk of bias for each trial, and performed data extraction. We utilized an intention-to-treat analysis strategy. We identified one RCT that involved 40 participants, and addressed the timing of surgery for people with recently symptomatic carotid artery stenosis. It compared very early surgery with surgery performed after 14 days of the last symptomatic event. The overall quality of the evidence was very low, due to the small number of participants from only one trial, and missing outcome data. We found no statistically significant difference between the effects of very early or delayed surgery in reducing the combined risk of stroke and death within 30 days of surgery (risk ratio (RR) 3.32; confidence interval (CI) 0.38 to 29.23; very low-quality evidence), or the combined risk of perioperative death and stroke (RR 0.47; CI 0.14 to 1.58; very low-quality evidence). To date, no results are available to confirm the optimal timing for surgery. There is currently no high-quality evidence available to support either very early or delayed cerebral revascularization after a recent ischemic stroke. Hence, further randomized trials to identify which patients should undergo very urgent revascularization are needed. Future studies should stratify participants by age group, sex, grade of ischemia, and degree of stenosis. Currently, there is one ongoing RCT that is examining the timing of cerebral revascularization.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 82 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 23%
Student > Bachelor 10 12%
Student > Ph. D. Student 8 10%
Other 6 7%
Student > Doctoral Student 4 5%
Other 11 13%
Unknown 24 29%
Readers by discipline Count As %
Medicine and Dentistry 20 24%
Nursing and Health Professions 16 20%
Social Sciences 4 5%
Neuroscience 3 4%
Pharmacology, Toxicology and Pharmaceutical Science 3 4%
Other 9 11%
Unknown 27 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 April 2019.
All research outputs
#7,948,265
of 14,656,415 outputs
Outputs from Cochrane database of systematic reviews
#8,577
of 11,037 outputs
Outputs of similar age
#112,513
of 263,167 outputs
Outputs of similar age from Cochrane database of systematic reviews
#142
of 179 outputs
Altmetric has tracked 14,656,415 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 11,037 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.5. This one is in the 21st percentile – i.e., 21% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 263,167 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.
We're also able to compare this research output to 179 others from the same source and published within six weeks on either side of this one. This one is in the 19th percentile – i.e., 19% of its contemporaries scored the same or lower than it.