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:10/13/2017)... , ... October 13, 2017 , ... “America On The ... identity. “America On The Brink” is the creation of published author, William Nowers. ... great-grandchildren. As a WWII veteran, he spent thirty years in the Navy. ...
(Date:10/12/2017)... New Orleans, LA (PRWEB) , ... October 12, 2017 , ... ... fitness centers in the U.S., announced today its plans to open a flagship location ... club will occupy the former Rooms To Go store next to Office Depot in ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of Medical Informatics (ACMI) will ... during the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual ... F. Collen, a pioneer in the field of medical informatics, this prestigious award is ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... has recently contributed a medical article to the newly revamped Cosmetic Town ... article spotlights the hair transplant procedure known as Follicular Unit Extraction ...
(Date:10/12/2017)... ... 12, 2017 , ... On Saturday, October 21, the Health & Wellness Center ... to raise money for the American Heart Association Heart Walk. Teams of up to ... together to keep their treadmills moving for 5 hours. Treadmills will start at 7:00 ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... , Oct. 11, 2017  Hill-Rom Holdings, Inc. ... Aspen Surgical facility in Las Piedras, Puerto ... scalpels and blades. ... that the facility sustained minor structural damage, temporary loss ... Maria. Repairs have been completed, manufacturing operations have resumed, ...
(Date:10/10/2017)... 2017   West Pharmaceutical Services, Inc. (NYSE: ... drug administration, today shared the results of a study ... the intradermal administration of polio vaccines. The study results ... May 2017 by Dr. Ondrej Mach , Clinical ... Organization (WHO), and recently published in the journal ...
(Date:10/5/2017)...  In response to the nationwide opioid epidemic, ... (AAOMS) released prescribing recommendations that urge ibuprofen – ... a first-line therapy to manage a patient,s acute ... Recognizing the value and importance of the ... Acute and Postoperative Pain Management" stresses that practitioners ...
Breaking Medicine Technology: