It's neck-and-neck down the long stretch for 2 stroke-prevention ...( ANN ARBOR Mich. Like horses running...),Health

ANN ARBOR, Mich. Like horses running down the long stretch of a race track, two different artery-opening treatments appear to be running neck-and-neck when it comes to preventing stroke among people with clogged neck arteries and other health problems.

After three years, patients who had a minimally-invasive procedure were just as likely to suffer a stroke or heart attack, or to die, as those who had open-neck surgery.

The findings should help guide the treatment of patients who need to have one of the two carotid arteries in their necks un-clogged to reduce their risk of a stroke but who face a high risk of complications during surgery because of other health issues. Such patients may do better with the minimally invasive option, called carotid stenting.

But the study, called SAPPHIRE, doesnt settle the question for many other patients, for whom the open surgery carotid endarterectomy is a tried-and-true option.

The results, from 260 patients who were randomly assigned to one of the two treatments at 29 hospitals, are published in the April 10 issue of the New England Journal of Medicine by researchers from the University of Michigan Cardiovascular Center, Harvard University and others. The study was funded by Cordis, a Johnson & Johnson company, which had no role in the analysis of study data.

Patients who are undergoing a procedure want to know that theyll be protected long-term from stroke, and that the procedure is safe, says Hitinder Gurm, M.D., the U-M interventional cardiologist who is the studys first author. This is the first study to suggest that stents do just as well long-term as surgery, in high-risk patients.

The studys senior and corresponding author is Donald Cutlip, M.D., executive director of clinical investigations at Harvard Universitys Clinical Research Institute. SAPPHIRE was led by Jay Yadav, M.D., formerly at the Cleveland Clinic and now at Piedmont Hospital in Atlanta.