Background and Purpose-The high risk of recurrence and comorbidity after a stroke associated with atrial fibrillation (AF) justifies an aggressive diagnostic approach so that anticoagulant treatment can be initiated. Methods-The clinical and paraclinical characteristics of consecutive ischemic stroke patients with and without documented AF were recorded. Independent predictive factors were then used to produce a predictive grading score for diagnosing AF, derived by logistic regression analysis: Score for the Targeting of Atrial Fibrillation (STAF). Results-STAF, calculated from the sum of the points for the 4 items (possible total score 0 to 8): age Ͼ62 years (2 points); NIHSS Ն8 (1 point); left atrial dilatation (2 points); absence of symptomatic intraor extracranial stenosis Ն50%, or clinico-radiological lacunar syndrome (3 points). STAF Ն5 identified patients with AF with a sensitivity of 89% and a specificity of 88%. Conclusions-STAF

Background and Purpose-We aimed at comparing the long-term benefit-risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis. Methods-Long-term follow-up study of patients included in Endarterectomy Versus Angioplasty in Patients WithSymptomatic Severe Carotid Stenosis (EVA-3S), a randomized, controlled trial of carotid stenting versus endarterectomy in 527 patients with recently symptomatic severe carotid stenosis, conducted in 30 centers in France. The main end point was a composite of any ipsilateral stroke after randomization or any procedural stroke or death. Results-During a median follow-up of 7.1 years (interquartile range, 5.1-8.8 years; maximum 12.4 years), the primary end point occurred in 30 patients in the stenting group compared with 18 patients in the endarterectomy group. Cumulative probabilities of this outcome were 11.0% (95% confidence interval, 7.9-15.2) versus 6.3% (4.0-9.8) in the endarterectomy group at the 5-year follow-up (hazard ratio, 1.85; 1.00-3.40; P=0.04) and 11.5% (8.2-15.9) versus 7.6% (4.9-11.8; hazard ratio, 1.70; 0.95-3.06; P=0.07) at the 10-year follow-up. No difference was observed between treatment groups in the rates of ipsilateral stroke beyond the procedural period, severe carotid restenosis (≥70%) or occlusion, death, myocardial infarction, and revascularization procedures. Conclusions-The long-term benefit-risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis favored endarterectomy, a difference driven by a lower risk of procedural stroke after endarterectomy. Both techniques were associated with low and similar long-term risks of recurrent ipsilateral stroke beyond the procedural period. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00190398.