Featured Research

from universities, journals, and other organizations

Surgery Unnecessary For 95 Percent Of Those With Asymptomatic Carotid Stenosis, Study Suggests

Date:
September 25, 2008
Source:
University of Western Ontario
Summary:
New research shows that with more intensive medical therapy, the risk of stroke has become so low that at least 95 percent of patients with asymptomatic carotid stenosis would be better off with medical therapy than with surgery or stenting. In the United States, one-half to two-thirds of the patients being subjected to surgery for revascularization are asymptomatic.

Research led by Dr. David Spence of Robarts Research Institute at The University of Western Ontario shows that with more intensive medical therapy, the risk of stroke has become so low that at least 95 per cent of patients with asymptomatic carotid stenosis (ACS) would be better off with medical therapy than with surgery or stenting.

ACS is a narrowing in the carotid artery, which supplies blood to the brain, which has not yet resulted in a stroke or transient ischemic attack (TIA). In the United States, one-half to two-thirds of the patients being subjected to surgery for revascularization are asymptomatic.

Spence will present his findings September 25th at the 6th World Stroke Congress being held in Vienna, Austria. He is the Director of the Stroke Prevention & Atherosclerosis Research Centre, a professor of neurology and clinical pharmacology at Western's Schulich School of Medicine & Dentistry and the author of "How to Prevent Your Stroke".

Spence says the less than five per cent of ACS patients who could benefit from revascularization can be identified with a procedure called Transcranial Doppler Embolus Detection: a helmet is placed on the head to hold ultrasound probes in place, and the arteries inside the head are monitored for microemboli, small blood clots or chunks of plaque that break off from the narrowing in the carotid artery and go into the brain arteries.

The historical benefit of revascularization for ACS was based on less intensive medical therapy than is now prevalent. Spence and a team of researchers studied 471 ACS patients. Of those, 199 were seen before 2003 and 272 after January 1, 2003. Microemboli were present in 12.6 per cent of patients before 2003, but in only 3.7 per cent since 2003. The decline in microemboli was associated with better control of plasma lipids and slower progression of carotid plaque. Since 2003, there have been significantly fewer strokes and hear attacks.

"The 96 per cent of patients without microemboli have only a one per cent risk of stroke in the next year, whereas the ones with microemboli have a 14 per cent risk of stroke," says Spence. "Since the risk of surgery is four to five per cent, patients without microemboli are better off with medical therapy including medications and lifestyle modifications. Only the ones with microemboli would benefit from carotid endarterectomy or stenting."


Story Source:

The above story is based on materials provided by University of Western Ontario. Note: Materials may be edited for content and length.


Cite This Page:

University of Western Ontario. "Surgery Unnecessary For 95 Percent Of Those With Asymptomatic Carotid Stenosis, Study Suggests." ScienceDaily. ScienceDaily, 25 September 2008. <www.sciencedaily.com/releases/2008/09/080925072424.htm>.
University of Western Ontario. (2008, September 25). Surgery Unnecessary For 95 Percent Of Those With Asymptomatic Carotid Stenosis, Study Suggests. ScienceDaily. Retrieved September 16, 2014 from www.sciencedaily.com/releases/2008/09/080925072424.htm
University of Western Ontario. "Surgery Unnecessary For 95 Percent Of Those With Asymptomatic Carotid Stenosis, Study Suggests." ScienceDaily. www.sciencedaily.com/releases/2008/09/080925072424.htm (accessed September 16, 2014).

Share This



More Mind & Brain News

Tuesday, September 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

FDA Eyes Skin Shocks Used at Mass. School

FDA Eyes Skin Shocks Used at Mass. School

AP (Sep. 15, 2014) The FDA is considering whether to ban devices used by the Judge Rotenberg Educational Center in Canton, Massachusetts, the only place in the country known to use electrical skin shocks as aversive conditioning for aggressive patients. (Sept. 15) Video provided by AP
Powered by NewsLook.com
Shocker: Journalists Are Utterly Addicted To Coffee

Shocker: Journalists Are Utterly Addicted To Coffee

Newsy (Sep. 13, 2014) A U.K. survey found that journalists consumed the most amount of coffee, but that's only the tip of the coffee-related statistics iceberg. Video provided by Newsy
Powered by NewsLook.com
'Magic Mushrooms' Could Help Smokers Quit

'Magic Mushrooms' Could Help Smokers Quit

Newsy (Sep. 11, 2014) In a small study, researchers found that the majority of long-time smokers quit after taking psilocybin pills and undergoing therapy sessions. Video provided by Newsy
Powered by NewsLook.com
'Fat Shaming' Might Actually Cause Weight Gain

'Fat Shaming' Might Actually Cause Weight Gain

Newsy (Sep. 11, 2014) A study for University College London suggests obese people who are discriminated against gain more weight than those who are not. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

      Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins