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Emeritus Professor of Vascular Surgery at the University of Oxford and Chair of the ESC Stroke Council. Alison is Past-President of the European Society for Vascular Surgery and Principal Investigator in the large ACST multi-national randomised Carotid Trials:
ACST-1, recruited over 3000 patients, randomising to either carotid surgery with medical treatment, or to medical treatment alone. Results clearly showed that surgery for tight asymptomatic carotid stenosis reduced the subsequent 10-year risk of stroke; the 5 and 10-year trial results were published in the Lancet (2004,2010)
ACST-2 compared surgery with stenting, again for tight asymptomatic carotid stenosis, and completed recruitment of 3625 patients. The 5-year results were presented as a 'hot topic' at ESC in August 2021 and simultaneously published in the Lancet. The trial is now in its final year of follow up and 10-year results should be available by September 2025
The ACST trials have influenced practice worldwide.
