| 2. |
- Ederle, Joerg, et al.
(författare)
-
Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
- 2010
-
Ingår i: The Lancet. - 1474-547X. ; 375:9719, s. 985-997
-
Tidskriftsartikel (refereegranskat)abstract
- Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006), Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). Interpretation Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.
|
|
| 3. |
- Greef, T.J., et al.
(författare)
-
Connected media and presence
- 2013
-
Ingår i: SAM 2013. - New York, NY, USA : ACM Press. - 9781450323949 ; , s. 43-48
-
Konferensbidrag (refereegranskat)abstract
- Effective design of shared mediated spaces, information and connectedness requires theory and practice from a range of disciplines such as found in European projects like Together Anywhere, Together Anytime (TA2) and the EIT ICT Labs Mediating Presence activity. Building on this work we continue to investigate the changes in the European digital media industry such as changed traditional distribution of media content and the progressive integration of (social) communication means in information distribution and shared mediated spaces. Our past research has given valuable insights in how to design and evaluate systems and services that provide a high quality of experience, in how trust is established in mediated environments, and how the formation of tacit communication between participants in new distributed and connected media is negotiated. In the new Seventh Framework Program project COnnected Media and Presence from European Institute of Technology (COMPEIT) we aim to enhance the quality of experience in face-to-face and broadcast communication further in three domains: 1) Spatial connectedness, 2) Social connectedness and 3) Information connectedness, by developing three key services: Shared Experience with Tangible Interaction (SETI); Broadcast Presence Studio (BPS) and Mixed-Reality Interaction (MRI). The quality of experience of these services will be enhanced in terms of for example: spatial connectedness, by providing shared spaces and supporting spatial features such as eye contact; social connectedness, by using natural means for interaction suiting different settings and activities; and information connectedness, by providing better means to share, manipulate and use information suiting different task or activities. In this paper we will discuss the background of this work and give an overview of our planned future work in COMPEIT.
|
|
