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Landmark Clinical Trial Shows Surgery and Stenting Equally Safe and Effective at Preventing Stroke
Date:5/26/2010

cedures was largely the same, with equal benefits for men and women, and for patients who had previously had a stroke and for those who had not. However, when the investigators looked at the numbers of heart attacks and strokes, they found differences: there were more heart attacks in the surgical group (2.3 percent compared to 1.1 percent in the stenting group) and more strokes in the stenting group (4.1 percent versus 2.3 percent for the surgical group) in the weeks following the procedure.

The study also found that the age of the patient made a difference. For patients aged 69 years and younger, stenting results were slightly better. In fact, the younger the patient was at the time of procedure, the larger the benefit of stenting. Conversely, for patients older than 70, surgical results were slightly superior. As the age of the patient increased so did the benefits of surgery over stenting.

According to L.N. Hopkins, M.D., chairman of University at Buffalo Neurosurgery, “The question is no longer whether we can use stents to prevent strokes. Now, it’s determining the best candidates.”

Stroke, the third leading cause of death in the United States, is caused by an interruption of blood flow to the brain by a clot or bleeding. Because carotid arteries on each side of the neck are the major source of blood flow to the brain, the buildup of cholesterol in the wall of the carotid artery, called atherosclerotic plaque, is a leading cause of stroke.

One of the strengths of the study, according to investigators, is that CREST was conducted in a variety of real-world settings, including large and small public and private hospitals, and by a number of different types of specialists, including neurosurgeons, cardiologists, neuroradiologists, interventional radiologists, and vascular surgeons. Most importantly, physicians had to demonstrate a high degree of proficiency and safety in order to participate in the
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Landmark Clinical Trial Shows Surgery and Stenting Equally Safe and Effective at Preventing Stroke
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