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Carotid stents associated with greater risk of stroke or death than carotid endarterectomy surgery
Date:10/11/2010

orts of results in patients not entered in trials, from the meta-analysis in this month's Archives and from the recently published results of the Carotid Revascularization Endarterectomy vs. Stenting Trial?" write Louis R. Caplan, M.D, of Beth Israel Deaconess Medical Center, Boston, and Thomas G. Brott, M.D., of Mayo Clinic, Jacksonville, Fla., in an accompanying editorial.

"Both therapeutic procedures are effective. Both procedures showed a relatively low rate of serious complications. Surgery is superior concerning some outcomes; stenting seems to have advantages in others," they write. In addition, "aggressive medical treatment of blood lipids, blood pressure and anti-platelets along with lifestyle changes may be as good as or better than either surgery or stenting at stroke and myocardial infarcts prevention."

"The past decades have produced three very effective treatmentsmedical, surgical and interventionalfor individuals with carotid artery disease," they conclude. "The results and complications of each can be improved. We have learned much from the trials and they are a beacon to engender even further improvements. However, care of individual patients will always rest in the hands of a trained experienced doctor on one end of a stethoscope and a patient on the other end. Trials can enlighten that encounter but never replace it."

(Arch Neurol. Published online October 11, 2010. doi:10.1001/archneurol.2010.268. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.


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Contact: Diane Keefe
diane.keefe@va.gov
857-203-5879
JAMA and Archives Journals
Source:Eurekalert

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