Featured Research

from universities, journals, and other organizations

New results in carotid artery stenosis versus endarterectomy

Date:
December 1, 2010
Source:
Mayo Clinic
Summary:
In a new article, researchers review the most current data available, especially the results of two recent, widely anticipated randomized studies, and provid a new analysis of the two major interventions for carotid occlusive disease.

Doctors have long known that patients with carotid artery stenosis, narrowed blood vessels in the neck, are at significant risk for a stroke. The condition has severe implications. Annually, in the United States, 795,000 patients have strokes that often result in long-term disability or death. For years, however, researchers in North America and Europe have tried to determine the most effective method to treat narrowed or partially blocked carotid vessels.

In the December issue of Mayo Clinic Proceedings, an interdisciplinary team of Mayo Clinic physicians reviewed the most current data available, especially the results of two recent, widely anticipated randomized studies, and provided a new analysis of the two major interventions for carotid occlusive disease.

In the review, the authors address a long-standing controversy as they point out that stenting, the decade-old procedure in which a tiny mesh scaffold is implanted to widen the vessel, can perform as well as endarterectomy, which is surgery to remove the blockage in the carotid vessels. "The medical literature up until now has largely come down against carotid stenting as an effective treatment, but the latest randomized studies suggest that for some populations and under some conditions, stenting may be as good as, if not better than, other modes of treatment," says lead author William Perkins, M.D., from the Mayo Clinic Department of Anesthesiology.

One significant factor affecting outcomes is the age of the patient. According to the Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) conducted at medical centers in the U.S. and Canada, and the International Carotid Stenting Study, stenting proved to be an effective treatment for patients younger than 70 who have symptoms related to the carotid occlusive disease.

For patients older than 70 who have severe stenosis, however, surgery provided a better option reducing stroke, although surgery offered no benefit over stenting when researchers added the risk of a subsequent heart attack. "There's a significant age effect that was borne out by both studies," Dr. Perkins says.

While neither of the studies were designed to examine the effect of experience it is likely that as with all other skills, experience matters. "Carotid artery stenting is relatively new and still evolving and there are fewer mentors with the depth of experience there is for carotid surgery," Dr. Perkins says. "At centers of excellence where stenting is done frequently, patients may have better outcomes than at places where it's not often performed."

The authors hope the review will help clinicians and patients make informed choices about which treatment is most appropriate to address each case of carotid occlusive disease. They hope the analysis also will encourage doctors to refer patients to medical centers with extensive experience performing the procedures. "I think these studies offer the best data so far indicating that stenting and surgery are both viable interventions and that there are patient populations that will benefit more from one treatment or the other," Dr. Perkins says.


Story Source:

The above story is based on materials provided by Mayo Clinic. Note: Materials may be edited for content and length.


Journal Reference:

  1. William J. Perkins, Guiseppe Lanzino, and Thomas G. Brott. Carotid Stenting vs Endarterectomy: New Results in Perspective. Mayo Clinic Proceedings, 2010; 85 (12)

Cite This Page:

Mayo Clinic. "New results in carotid artery stenosis versus endarterectomy." ScienceDaily. ScienceDaily, 1 December 2010. <www.sciencedaily.com/releases/2010/12/101201121640.htm>.
Mayo Clinic. (2010, December 1). New results in carotid artery stenosis versus endarterectomy. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2010/12/101201121640.htm
Mayo Clinic. "New results in carotid artery stenosis versus endarterectomy." ScienceDaily. www.sciencedaily.com/releases/2010/12/101201121640.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com
Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
Can Watching TV Make You Feel Like A Failure?

Can Watching TV Make You Feel Like A Failure?

Newsy (July 24, 2014) A study by German researchers claims watching TV while you're stressed out can make you feel guilty and like a failure. 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