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ACST-2 - Asymptomatic Carotid Surgery Trial 2

Overview

ACST-2 (ISRCTN21144362) was the largest randomised trial of carotid stenting (CAS) versus carotid endarterectomy (CEA) for long-term stroke prevention.

The results showed that both stenting and surgery are low-risk and similarly effective procedures for treating carotid artery disease. The results were published in The Lancet, and announced simultaneously at the European Society of Cardiology Congress 2021.

The long-term results were presented at the European Society of Cardiology Congress 2025, and will give doctors confidence in offering the procedure most suited to their patients.

 

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Participating Centres

The ACST-2 trial included collaborators from 33 countries worldwide: Argentina, Austria, Belgium, Brazil, Bulgaria, Canada, China, Croatia, the Czech Republic, Egypt, Estonia, France, Germany, Greece, Hungary, the Republic of Ireland, Israel, Italy, Japan, Kazakhstan, the Netherlands, Norway, Poland, Portugal, Russia, Serbia, the Slovak Republic, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and the United States.

Funding

ACST-2 is funded currently by the British Heart Foundation and by core support from the Medical Research Council (MRC), the British Heart Foundation, and Cancer Research UK. It previously received grants from the BUPA Foundation and the National Institute for Health and Care Research Health Technology Assessment programme.

 

Our team

News

Selected publications

More publications

external collaborators

Professor Leo Bonati

Professor Leo Bonati
Co-Principal investigator

Johanna Chester

Johanna Chester
Italian Recruitment Coordinator

Study documentation

Read the study documentation for ACST-2:

Contact us

Address:
Asymptomatic Carotid Surgery Trial-2 (ACST-2)
Richard Doll Building
University of Oxford
Old Road Campus
Headington
Oxford
OX3 7LF
United Kingdom

Tel: +44 (0)1865 617979

Email: acst@nds.ox.ac.uk

Related research themes

Randomised trials
Randomised trials
Cardiovascular disease (CVD) includes all the diseases of the heart and circulation including coronary heart disease, angina, heart attack, congenital heart disease and stroke. Despite improvements in the prevention and treatment of CVD in recent decades, it remains the leading cause of death worldwide, particularly in developed countries.
Cardiovascular disease