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Stents and surgery for blocked neck arteries are neck-and-neck as lasting stroke prevention
Date:2/1/2012

ry experience, a much higher rate of restenosis with stents had been expected. "Because you are leaving a foreign body behind in the artery and the artery is pulsating with every heartbeat, the belief was that with each of these pulsations the stent would perhaps irritate the artery and cause a reaction and restenosis."

Now, he says that theory can be modified, with the recognition that the size of an artery makes a big difference. Coronary arteries are very small, about two millimeters wide. "If the coronaries develop even a small layer of recurrence within them, it occupies 50-60 percent of the inside of the vessel (lumen), a significant loss. On the other hand, carotid arteries are three-to-five times the size of the coronary arteries, so you don't lose that much lumen," says Dr. Lal. "It's almost as if the carotid artery passage has so much more resilience, because it's got a lot of reserve, and if you lose a proportion of that channel, you still have enough blood flowing."

Prior to this study, Dr. Lal says the U.S. Food and Drug Administration had approved stenting for patients who were not good candidates for surgery. The FDA cited CREST in its approval of an expanded indication for use of the stent to include all patients with clogged carotid arteries who are at risk for stroke.


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Contact: BILL SEILER
bseiler@umm.edu
410-328-8919
University of Maryland Medical Center
Source:Eurekalert

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