Navigation Links
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 patients already exhibiting symptoms of carotid disease, estimated four-year rates of stroke and death was 8 percent if they underwent stenting, but just 6.4 percent if they had the surgery. Among those who did not have symptoms, the rate was 4.5 percent versus 2.7 percent, respectively.

People who underwent stenting had a slightly higher odds for death in the weeks following the procedure compared to those who underwent surgery (0.7 percent versus 0.3 percent), and they also had a higher risk for stroke during the weeks after the procedure. However, the odds for heart attack during this time period were less for those undergoing stenting (1.1 percent) versus surgery (2.3 percent), the team said. Rates for recurrent stroke were low among both groups (between 2 percent and 3 percent).

Based on the findings, "we now have two safe and effective methods to treat carotid artery disease that can be targeted to individual patients," Mayo Clinic neurologist and study co-author Dr. James Meschia said in the news release.

"As outcomes continue to improve, so does the opportunity for stroke prevention in an expanding number of patients," added co-principal investigator for stenting Dr. Gary Roubin, chairman of the department of cardiovascular medicine at Lenox Hill Hospital in New York City. "The potential now exists for a less invasive, less expensive outpatient approach to treating carotid stenosis," he said in a hospital news release.

In their editorial in the journal, Drs. Stephen M. Davis and Geoffrey A. Donnan of the University of Melbourne, Australia, said that while the results are promising, "more long-term data are needed before a full appreciation of the relative risks and benefits of the two procedures can be made." In the meantime, they say, decisions may best be made on a case-by-case basis and "the individualization of treatment choices is appropriate."

More information

Learn the warning signs of stroke at the American Heart Association.



-- E.J. Mundell



SOURCES: May 26, 2010, New England Journal of Medicine, online; May 26, 2010, news release, Lenox Hill Hospital, New York City; Mayo Clinic, Jacksonville, Fla.


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Blue Cross and Blue Shield Association Expands Blue Distinction(R) Designation to Include Spine Surgery, Knee and Hip Replacement
2. Cutting-Edge Surgery, Seamlessly Performed
3. American Stroke Association Late-Breaking Science Report: Surgery, Stenting to Open Blocked Neck Arteries Similar in Safety, Efficacy, But Show Differences in Stroke, Heart Attack and Death Rates at Certain Ages
4. Nationally Known Interventional Neuroradiologist John Pile-Spellman, M.D., Joins Neurological Surgery, P.C.
5. Breathing Obstructions Caused by Sinusitis can Require Surgery, says Denver's Nose Doc
6. EPIC study finds new embolic protection device had 97.5 percent success rate during carotid artery stenting
7. Aspirin Alone Works Best to Prevent Clots a Year After Stenting
8. Stenting May Save Legs
9. Bailout stenting successful treatment for infants with constricted aortas
10. Two Surgical Methods Equally Successful for Prostate Cancer
11. Two Sepsis Treatments Look Equally Effective
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/18/2017)... ... January 18, 2017 , ... At Hallmark Nameplate, their commitment ... they have achieved certification to ISO 13485. This certification is another way they are ... date products and services that they need. , The ISO 13485 Certification is a ...
(Date:1/18/2017)... ... 2017 , ... The Hear the World Foundation, a Sonova ... of cochlear implants. In February 2017, the first three children with profound hearing ... leading an independent life. This engagement builds on the support the Hear the ...
(Date:1/17/2017)... ... January 17, 2017 , ... January is National Stalking Awareness Month (NSAM), now ... in the corners and commit the crime of stalking, a very real danger to many ... often overlooked factor in stalking and other crimes. , “Stalking: know it. Name it. Stop ...
(Date:1/17/2017)... ... January 17, 2017 , ... For breast cancer clinicians and ... or those who desire a more intimate review and analysis of its highlights, a ... to Bedside—is being offered by Imedex on February 4, 2017 in Chicago. Chaired by ...
(Date:1/17/2017)... ... January 17, 2017 , ... Kevin Harrington (one of the original Sharks from ... campaigns regarding the topic of Beauty and Personal Care. , Everyone ... better way to commit to these changes than beginning with personal care and beauty ...
Breaking Medicine News(10 mins):
(Date:1/18/2017)... , Jan. 18, 2017  Tarix Orphan LLC ... has granted a Rare Pediatric Disease (RPD) designation for ... Recessive Dystrophic Epidermolysis Bullosa (RDEB), a rare genetic skin ... and treatment is limited to supportive care. ... Orphan Drug Designation previously granted by the FDA in ...
(Date:1/18/2017)... 2017  Astellas Pharma Inc. (President and CEO: ... its participation in Access Accelerated, a global, multi-stakeholder ... prevention, diagnostics and treatment in low-income and lower-middle ... companies and in collaboration with the World Bank ... (UICC), Astellas will work towards the United Nations ...
(Date:1/17/2017)... DUBLIN , Jan 17, 2017 Research ... Pancreas Devices System Market 2016-2020" report to their offering. ... The global artificial ... during the period 2016-2020. Global Artificial Pancreas Devices System ... with inputs from industry experts. The report covers the market landscape ...
Breaking Medicine Technology: