Stenting As Effective As Invasive Neck Surgery For Long-Term Stroke Prevention
Using stents to keep neck arteries open is just as effective as invasive neck surgery for long-term prevention of fatal and disabling strokes, suggests a new study.
Carotid arteries supply blood to the brain and carotid artery disease occurs when cholesterol and fatty deposits build up in these arteries, restricting blood flow and increasing the risk of stroke.
Surgeons in UK treat carotid artery disease with an invasive surgical procedure called endarterectomy.
Stenting is an alternative procedure in which a small mesh cylinder - stent - is used to keep the artery open. The procedure is less invasive and causes only minor bruising in the groin, hence no risk of nerve damage.
"At the moment, stenting is not widely used in the UK due to historical uncertainty over its long-term effectiveness," said study leader Professor Martin Brown from the UCL Institute of Neurology, in the press release.
"However, we have now shown that stenting is just as good as endarterectomy for preventing fatal and disabling strokes. We have also shown that the risk of stroke during the procedure is no higher for stenting than for endarterectomy in younger patients. The risks of each procedure are different and will vary depending on the patient, but stenting should be offered as an option to many more patients under the age of 70."
"One of the issues is that there are not many centers in this country that currently offer stenting as an option so the patient choice is not there. Now that we know stenting is effective in the long term, more staff should be trained to carry out the procedure and gain experience. Otherwise there is a vicious cycle where nobody at a centre has stenting experience so patients are only offered endarterectomy and staff cannot learn or observe the procedure. In other countries, stenting is more widespread and the safety of the procedure improves as staff gain experience."
The study has been published in the journal Lancet.