Featured Research

from universities, journals, and other organizations

Test for blocked neck arteries only necessary for people with stroke risk factors, guidelines suggest

Date:
January 31, 2011
Source:
American Heart Association
Summary:
New multi-agency guidelines recommend against widespread screening for blocked neck arteries, using ultrasound to detect the condition only in people with symptoms or other stroke risk factors. For people with severely narrowed neck arteries, especially when stroke warning symptoms have occurred, either surgery or inserting a stent is a reasonable approach to reducing stroke risk, experts say.

Widespread screening or routine ultrasound for blocked neck arteries to determine stroke risk isn't necessary, according to new guidelines from the American Heart Association/American Stroke Association, American College of Cardiology and other groups.

Related Articles


Carotid endarterectomy and carotid stenting are reasonable and effective ways to treat blocked neck arteries, though some patients may be a better candidate for one procedure over the other, the guidelines also state.

When the carotid arteries on the side of the neck or vertebral arteries alongside the spinal column become clogged, less blood gets to the brain and the risk of stroke increases.

The guidelines writing committee, which included a wide range of specialists on stroke prevention, agreed there isn't sufficient evidence of benefit for widespread screening. "However, if your doctor hears abnormal blood flow when listening to your neck arteries, or if you have two or more risk factors for stroke (such as high cholesterol or a family history), then it is a reasonable approach," said Jonathan L. Halperin, M.D., co-chair of the writing committee and Professor of Medicine at the Mount Sinai School of Medicine in New York.

"The guidelines will provide new information and evidence to help clinicians select treatment approaches with their patients," said Thomas G. Brott, M.D., committee co-chair, Professor of Neurology and director of research at the Mayo Clinic campus in Jacksonville, Fla.

Stroke risk factors include age, family history of stroke, high blood pressure, high blood cholesterol, diabetes, obesity, atrial fibrillation, physical inactivity, sickle cell disease and other heart or blood vessel diseases.

Among dozens of recommendations, the writing group also noted that two often competing procedures are used to restore adequate blood flow to the brain past severely narrowed arteries. In carotid endarterectomy, used for half a century, plaque buildup is surgically removed. In stenting, which has been available for about 15 years, a balloon catheter is inserted to open the vessel and a metal mesh tube (stent) is left in place to keep the blood vessel open.

After reviewing the evidence, including two recent head-to-head comparisons, the writing committee concluded that both approaches are reasonable and safe when arteries are more than 50 percent blocked.

"The guidelines support carotid surgery as a tried-and-true treatment for most patients," Brott said. "However, for patients who have a strong preference for less invasive treatments, carotid stenting offers a safe alternative. Because of the anatomy of their arteries or other individual considerations, some patients may be more appropriate for surgery and others for stenting."

Furthermore, medications offer a better alternative than either surgery or stenting for many patients, according to the guidelines. In the latest clinical trials comparing the procedures, all patients received optimal medical treatment and there were no medication-only groups.

"The risks of these procedures have fallen considerably, but you need to make sure you have very experienced practitioners performing the latest techniques," Halperin said.

The full text of the guidelines will be published in Circulation: Journal of the American Heart Association; Stroke: Journal of the American Heart Association, and Journal of the American College of Cardiology. The guideline executive summary will be in Catheterization and Cardiovascular Interventions, Journal of Cardiovascular Computed Tomography, Journal of NeuroInterventional Surgery, Journal of Vascular Surgery, and Vascular Medicine.

The guidelines were developed with the American Association of Neuroscience Nurses; American Association of Neurological Surgeons; American Society of Neuroradiology; American College of Radiology; Congress of Neurological Surgeons; Society for Atherosclerosis Imaging and Prevention; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society for NeuroInterventional Surgery; Society for Vascular Medicine; and Society for Vascular Surgery.

The American Academy of Neurology and the Society of Cardiovascular Computed Tomography collaborated in the process.

Co-authors on the writing committee are: Suhny Abbara, M.D.; J. Michael Bacharach, M.D.; John D. Barr, M.D.; Ruth L. Bush, M.D., M.P.H.; Christopher U. Cates, M.D.; Mark A. Creager, M.D.; Susan B. Fowler, Ph.D.; Gary Friday, M.D.; Vicki S. Hertzberg, Ph.D.; E. Bruce McIff, M.D.; Wesley S. Moore, M.D.; Peter D. Panagos, M.D.; Thomas S. Riles, M.D.; Robert H. Rosenwasser, M.D.; and Allen J. Taylor, M.D.


Story Source:

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


Journal Reference:

  1. Thomas G. Brott, Jonathan L. Halperin, Suhny Abbara, J. Michael Bacharach, John D. Barr, Ruth L. Bush, Christopher U. Cates, Mark A. Creager, Susan B. Fowler, Gary Friday, Vicki S. Hertzberg, E. Bruce McIff, Wesley S. Moore, Peter D. Panagos, Thomas S. Riles, Robert H. Rosenwasser, and Allen J. Taylor. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart. Circulation, January 31, 2011 DOI: 10.1161/CIR.0b013e31820d8d78

Cite This Page:

American Heart Association. "Test for blocked neck arteries only necessary for people with stroke risk factors, guidelines suggest." ScienceDaily. ScienceDaily, 31 January 2011. <www.sciencedaily.com/releases/2011/01/110131153255.htm>.
American Heart Association. (2011, January 31). Test for blocked neck arteries only necessary for people with stroke risk factors, guidelines suggest. ScienceDaily. Retrieved November 21, 2014 from www.sciencedaily.com/releases/2011/01/110131153255.htm
American Heart Association. "Test for blocked neck arteries only necessary for people with stroke risk factors, guidelines suggest." ScienceDaily. www.sciencedaily.com/releases/2011/01/110131153255.htm (accessed November 21, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, November 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

UN Says It Will Scale Up Its Ebola Response

UN Says It Will Scale Up Its Ebola Response

AFP (Nov. 20, 2014) UN Resident Coordinator David McLachlan-Karr and WHO representative in the country Daniel Kertesz updated the media on the UN Ebola response on Wednesday. Duration: 00:51 Video provided by AFP
Powered by NewsLook.com
Takata Offers "sincerest Condolences" To Victims of Malfunctioning Airbag

Takata Offers "sincerest Condolences" To Victims of Malfunctioning Airbag

Reuters - US Online Video (Nov. 20, 2014) U.S. Congress hears from a victim and company officials as it holds a hearing on the safety of Takata airbags after reports of injuries. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
Obesity Costs Almost As Much As War And Terrorism

Obesity Costs Almost As Much As War And Terrorism

Newsy (Nov. 20, 2014) The newest estimate of the cost of obesity is pretty jarring — $2 trillion. But how did researchers get to that number? Video provided by Newsy
Powered by NewsLook.com
Calling All Men: Here's Your Chance to Experience Labor Pains

Calling All Men: Here's Your Chance to Experience Labor Pains

Reuters - Light News Video Online (Nov. 20, 2014) Chinese hospital offers men a chance to experience the pain of child birth via electric shocks. Sharon Reich reports. Video provided by Reuters
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:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

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