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Stents May Be Effective Weapon Against Stroke
Date:2/26/2010

One study finds they are equal to artery-clearing surgery, but another trial does not

FRIDAY, Feb. 26 (HealthDay News) -- Both stents and conventional surgery appear to be equally effective in preventing strokes in people whose carotid arteries are blocked, according to research presented Friday at the American Stroke Association's annual meeting in San Antonio.

However, a second stents-versus-surgery trial, published Thursday in The Lancet, seemed to give surgery better marks, so the jury may still be out on which approach is better in shielding patients from stroke.

"I think both procedures are excellent and I'm happy to say we have two good options to treat patients," said Dr. Wayne M. Clark, professor of neurology and director of the Oregon Stroke Center, Oregon Health Sciences University in Portland, and a co-author of the stroke association study.

"I think the [ASA] trial is really a positive for both stenting and surgery," said Dr. Craig Narins, associate professor of medicine at the University of Rochester Medical Center in New York, who was not involved with the study. "I think this is going to change the way that physicians look at carotid artery disease."

That study, the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), was funded by the U.S. National Institute of Neurological Disorders and Stroke and Abbott, which makes the carotid stents.

"There has been a lot of skepticism about the ability of stenting to equal surgery and this trial pretty nicely shows that it does equal it overall," Narins added.

But the findings from CREST need to be squared with the second trial, the International Carotid Stenting Study (ICSS). That European trial found that surgery remained superior to stenting in the short-term, and stenting did not appear to be as safe as surgery.

"They're very similar studies, although the European [ICSS] study didn't use e
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