RNS: Stroke preventing procedures are neck-and-neck, April 2008
TIME: 2:04
They’re neck-and-neck down the long stretch:
Two stroke-prevention procedures give similar benefit
Suggested lead: Each year, three-quarters of a million Americans suffer a stroke, and 160,000 of them die. But some strokes can be prevented by opening up blockages in the neck arteries. Now, a new study led by a University of Michigan doctor reveals that two different treatment options are equally good for this kind of stroke prevention. Kara Gavin has more:
Like horses running down the long stretch of a race track, two different treatments appear to be running neck-and-neck when it comes to preventing stroke among people with clogged neck arteries and other health problems.
After three years, patients who had a minimally-invasive procedure on their carotid arteries were just as likely to suffer a stroke or heart attack, or to die, as those who had a more invasive, open-neck surgery.
The findings should help guide the treatment of patients who face a high risk of problems during surgery. Such patients may do better with the minimally invasive option, called carotid stenting.
But the study doesn’t settle the question for many other patients, for whom the open surgery — carotid endarterectomy — is a tried-and-true, and safe, option.
The results were published in the April 10 issue of the New England Journal of Medicine by a team led by University of Michigan cardiologist Dr. Hitinder Gurm.
"In the study, we found there was no difference in outcome of these patients with respect to their total survival or the risk of stroke. So overall, although this is the first study, we did not find a difference to say one strategy is superior to the other as far as the long-term outcome goes."
The two procedures both aim to do the same thing. That is, to reduce the chance that a patient will suffer a stroke because a blood clot forms in a narrowed, plaque-clogged carotid artery, and then travels to the brain.
"The patient who is undergoing a procedure wants to know that they’ll be protected long-term from this complication of stroke. The procedure has to be safe, but more importantly, it has to be beneficial to the patient, and we have a gold standard; we have surgical endarterectomy that has been around for 50 years and we know it works in certain group of patients. This is the first study that suggests that the stents do as well long-term as surgery."
As many as one in four American adults have some narrowing of the carotid arteries, and five percent have severe blockages. Now, this new study will help guide many of them to the best, and safest, treatment.
Kara Gavin, U-M Health System News.
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