Stroke Treatment Unclogs Neck Arteries
Reported April 14, 2008
(Ivanhoe Newswire) — Now, there is a minimally invasive and effective treatment option for patients suffering from clogged neck arteries — a condition that often leads to stroke.
One in four adults in the United States have some blockage of their two carotid arteries. About five percent of women over age 65 and a slightly higher percentage of men in the same age group have at least one blockage cutting the blood flow of the opening in half. A stroke may result if the clot travels to the brain.
To reduce the risk of stroke, patients often need a procedure to remove the plaque buildup. Typically, carotid endarterectomy — a surgery requiring an open incision in the neck, below the jaw — is performed. But a recent study reveals another option is just as effective: carotid stenting, a procedure requiring only a tiny incision in the arm or groin through which a tiny wire-mesh tube is threaded up into the neck to hold open the blocked artery.
The three-year study looked at 260 patients randomly assigned to receive one of the two procedures. Researchers found no difference between the treatments, saying the results are statistically equivalent: within the first three years, 41 of the 143 patients who received carotid stents and 45 of the 117 patients who had open surgery suffered from a heart attack or stroke, or died.
Experts say the minimally invasive option may be useful for patients who are at a high risk for complications during surgery from other health issues like heart failure, lung disease or a history of radiation therapy. Outside of trials, I do not think a person with average surgical risk should undergo stenting, Hitinder Gurm, M.D., study author and an assistant professor of internal medicine at the University of Michigan Medical School in Ann Arbor and the VA Ann Arbor Healthcare Center, was quoted as saying. But for high-risk patients, we can now be certain that they will have a similar long-term outcome from stenting as they would have had from surgery.
SOURCE: The New England Journal of Medicine, 2008;358:1572-1579
