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Surgery, Stenting Fare Equally Well in Preventing Stroke
Date:5/26/2010

Both methods have pros, cons in clearing blocked neck artery, study shows

WEDNESDAY, May 26 (HealthDay News) -- The latest major trial pitting invasive surgery against less invasive stenting to help prevent stroke shows that each is a safe, effective option.

Researchers report in the May 26 online edition of the New England Journal of Medicine that the study, which involved more than 2,500 patients treated at 117 centers across North America between 2000 and 2008, sought to determine if surgery to remove plaque from the carotid artery (running up the neck to the brain) was better or worse than the placement of an artery-opening stent. Blockages in the carotid artery are a major cause of stroke.

Other large trials have compared the two techniques, but this study was unique, the authors say, because half of the patients had symptoms of heart disease in the carotid artery, while the other half were symptom-free. That's important, the team said, because about half of the more than 140,000 carotid procedures performed in the United States annually occur in patients who have not yet developed symptoms.

After a median follow-up of 2.5 years, the team found no significant difference in rates of stroke, heart attack or death for patients receiving surgery versus stents. Overall, 7.2 percent of patients receiving stents went on to experience stroke, heart attack or death, compared to 6.8 percent of those undergoing the artery-clearing surgery.

The study found "excellent safety and long-term results for patients with warning signs for stroke as well as for patients without such warning signs," the study's national principal investigator, Dr. Thomas G. Brott, a professor of neurology and director for research at the Mayo Clinic in Jacksonville, Fla., said in a Mayo news release.

There were some key differences between the two procedures based on the type of patient, however. For example, for patient
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