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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Stroke, Outcome 1 Stroke and death < 30days.
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Analysis 1.1

Comparison 1 Stroke, Outcome 1 Stroke and death < 30days.

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Comparison 1 Stroke, Outcome 2 Perioperative death and all strokes.
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Analysis 1.2

Comparison 1 Stroke, Outcome 2 Perioperative death and all strokes.

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Summary of findings for the main comparison. Very early cerebral revascularization compared with delayed treatment for recently symptomatic carotid artery stenosis

Very early cerebral revascularization compared with delayed treatment for recently symptomatic carotid artery stenosis

Patient or population: people with recently symptomatic carotid artery stenosis

Settings: hospital

Intervention: very early cerebral revascularization (within two days)

Comparison: delayed treatment (after two days)

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Very early cerebral revascularization

Delayed Treatment

Stroke and Death < 30 days

This outcome was poorly reported

RR 3.3 (0.4 to 29.2)

40 (1 study)

⊝⊝⊝
very low1,2,3

Perioperative death and strokes

This outcome was poorly reported

RR 0.5 (0.1 to 1.6)

40 (1 study)

⊝⊝⊝
very low1,2,3

Lenght of hospital stay

This outcome was poorly reported: One study reported no difference between groups. No standard deviation was reported.

Myocardial infarction < 30 days

This outcome was not reported

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk Ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Downgraded one level: one study with small sample size

2Downgraded one level due to risk of bias: incomplete outcome data

3Downgraded one level due to uncertainty in outcome measurement

Figuras y tablas -
Summary of findings for the main comparison. Very early cerebral revascularization compared with delayed treatment for recently symptomatic carotid artery stenosis
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Comparison 1. Stroke

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Stroke and death < 30days Show forest plot

1

40

Risk Ratio (M‐H, Random, 95% CI)

3.32 [0.38, 29.23]

2 Perioperative death and all strokes Show forest plot

1

40

Risk Ratio (M‐H, Random, 95% CI)

0.47 [0.14, 1.58]
Figuras y tablas -
Comparison 1. Stroke
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