Log in with your email address username.

×

Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

[Comment] Age and carotid intervention outcomes

In The Lancet, the Carotid Stenting Trialists’ Collaboration (CSTC) present a meta-analysis of the effect of increasing age on perioperative death or stroke related and late ipsilateral stroke in 4754 symptomatic patients randomised to carotid endarterectomy (CEA) or carotid artery stenting (CAS) in three European randomised controlled trials (RCTs; EVA-3S, SPACE, and ICSS) and one North American RCT (CREST).1 Key findings were that once the perioperative period (between randomisation and 120 days) passed, there was no difference in late ipsilateral stroke between CEA and CAS, irrespective of age, and that increasing age had no effect on procedural risks after CEA, but there was a stepwise increase in perioperative stroke or death after CAS, contributing to the CAS versus CEA treatment difference, which became apparent at 65–69 years of age (hazard ratio 1·81, 95% CI 0·97–3·38) and most pronounced over the age of 70 (2·28, 1·39–3·75).

email