2023BASIL-2RevascularisationIn 345 patients with chronic limb-threatening ischaemia requiring infra-popliteal revascularisation, a vein-bypass-first strategy worsened amputation-free survival compared with a best-endovascular-treatment-first strategy.
2022BEST-CLIRevascularisationIn 1,830 patients with chronic limb-threatening ischaemia and infra-inguinal disease, surgical bypass reduced major adverse limb events or death compared with endovascular therapy, but only in those with an adequate single-segment great saphenous vein.
2021ACST-2Carotid diseaseIn 3,625 asymptomatic patients with severe carotid stenosis, carotid artery stenting produced similar rates of procedural death or disabling stroke and 5-year non-procedural stroke compared with carotid endarterectomy.
2020VOYAGER PADAntithrombotic therapyIn 6,564 patients with peripheral artery disease after lower-extremity revascularisation, rivaroxaban 2.5 mg twice daily plus aspirin reduced acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke or cardiovascular death compared with aspirin alone.
2017EUCLIDAntithrombotic therapyIn 13,885 patients with symptomatic peripheral artery disease, ticagrelor monotherapy did not reduce cardiovascular death, myocardial infarction or ischaemic stroke compared with clopidogrel monotherapy.
2016EVAR-1Aortic aneurysmIn 1,252 patients with a large asymptomatic abdominal aortic aneurysm fit for either procedure, endovascular aneurysm repair gave an early survival benefit but inferior late all-cause and aneurysm-related mortality compared with open surgical repair.
2014IMPROVEAortic aneurysmIn 613 patients with a clinical diagnosis of ruptured abdominal aortic aneurysm, an endovascular-first strategy did not reduce 30-day mortality compared with emergency open repair.
2013INSTEAD-XLAortic dissectionIn 140 patients with stable uncomplicated type B aortic dissection, thoracic endovascular aortic repair added to optimal medical therapy reduced 5-year aorta-specific mortality and disease progression compared with optimal medical therapy alone.
2010CRESTCarotid diseaseIn 2,502 patients with symptomatic or asymptomatic carotid stenosis, carotid-artery stenting did not differ from carotid endarterectomy for periprocedural stroke, myocardial infarction or death, or subsequent ipsilateral stroke at 4 years.
1998UK Small Aneurysm TrialAortic aneurysmIn 1,090 patients aged 60–76 years with a symptomless abdominal aortic aneurysm of 4.0–5.5 cm, early elective open repair did not reduce long-term all-cause mortality compared with ultrasonographic surveillance.