Featured Research

from universities, journals, and other organizations

Re-blockage rates low in both stented and surgically-opened arteries, study finds

Date:
February 1, 2012
Source:
American Heart Association
Summary:
In a large, head-to-head comparison of two procedures that clear blocked neck arteries, outcomes were similar. The study found that 94 percent of the arteries remained open two years after using surgery or a metal stent.

Opening blocked neck arteries with a metal stent or surgery were equally durable, in research presented at the American Stroke Association's International Stroke Conference 2012.

Two years after the procedures, less than 7 percent of patients had developed repeat blockages (restenosis), researchers said.

"Unlike bare metal stents placed in coronary arteries, where re-blockage occurs about 20 percent of the time, we found the re-blockage rates in the carotid artery were quite small," said Brajesh K. Lal, M.D., lead author of this analysis and associate professor of vascular surgery at the University of Maryland School of Medicine in Baltimore. "Patients and physicians can be reassured that both procedures are durable and that re-blockage rates are equivalent, so they can use different criteria to determine which procedure is right for a patient."

The study is the largest to look at restenosis rates after either procedure.

The study participants -- part of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) -- had partial blockages in a neck artery. Symptomatic patients had experienced a non-disabling stroke or transient ischemic attack (mini-stroke) because of the blockage, while asymptomatic patients had not.

Previously, this head-to-head comparison of the two procedures showed no difference in the combined rates of stroke, heart attack or death between patients undergoing surgical removal of a blockage (carotid endarterectomy) or stenting.

About 10 percent of strokes are caused by blockages in the neck arteries, which supply blood to the brain. Revascularization procedures preserve blood flow and lower the risk of stroke.

In the current study, 1,086 patients received stenting and 1,105 endarterectomy. All were assessed at one, six, 12 and 24 months after the procedure with an ultrasound to identify those who had developed a 70 percent or greater blockage in the treated section.

After two years, the researchers found:

  • Identical rates of restenosis (5.8 percent) after stenting and endarterectomy.
  • Complete blockage (occlusion) in 0.3 percent after stenting and 0.5 percent after endarterectomy.
  • Combined restenosis/occlusion in 6 percent after stenting and 6.3 percent after endarterectomy.
  • Twenty stent patients and 23 endarterectomy patients had undergone a second procedure to open a re-blocked carotid.
  • Rates of restenosis were about double in women and patients with diabetes and abnormal lipid levels.
  • Stroke rates were 4 times higher in patients who developed a restenosis compared to those that did not develop a restenosis during follow-up.

"These may be groups we need to focus more on by monitoring them closely and aggressively controlling risk factors after the procedures," said Lal, who is also chief of vascular surgery at the Baltimore VA Medical Center in Maryland.

Physicians from different specialties perform revascularization procedures. In the study, results didn't differ by specialty.

"CREST was unique in having a built-in training and credentialing process that mandated participating physicians perform 1,500 revascularization procedures before randomizing any patients," Lal said. "These results provide hard data for the FDA and professional societies to use as they recommend a particular type or extent of training for performing these procedures."

Monitoring of CREST participants will continue through 10 years.

Co-authors are: Kirk E. Beach, M.D., Ph.D.; Gary S. Roubin, M.D.; Helmi L. Lutsep, M.D.; Wesley S. Moore, M.D.; Mahmoud B. Malas, M.D.; David Chiu, M.D.; Nicole R. Gonzales, M.D.; James L. Burke, M.D.; Michael Rinaldi, M.D.; James R. Elmore, M.D.; Fred A. Weaver, M.D.; Craig R. Narins, M.D.; Malcolm Foster, M.D.; Kim Hodgson, M.D.; Alexander D. Shepard, M.D.; James F. Meschia, M.D.; Robert O. Bergelin, M.S.; Jenifer Voeks, Ph.D.; George Howard, Dr.P.H.; and Thomas G. Brott, M.D.

The study is funded by the National Institute of Neurological Disorders and Stroke and Abbott Vascular Solutions (formerly Guidant), which included donations of the Acculink and Accunet stent systems to most of the CREST centers.


Story Source:

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


Cite This Page:

American Heart Association. "Re-blockage rates low in both stented and surgically-opened arteries, study finds." ScienceDaily. ScienceDaily, 1 February 2012. <www.sciencedaily.com/releases/2012/02/120201094313.htm>.
American Heart Association. (2012, February 1). Re-blockage rates low in both stented and surgically-opened arteries, study finds. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2012/02/120201094313.htm
American Heart Association. "Re-blockage rates low in both stented and surgically-opened arteries, study finds." ScienceDaily. www.sciencedaily.com/releases/2012/02/120201094313.htm (accessed April 17, 2014).

Share This



More Health & Medicine News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Thousands Of Vials Of SARS Virus Go Missing

Thousands Of Vials Of SARS Virus Go Missing

Newsy (Apr. 16, 2014) A research institute in Paris somehow misplaced more than 2,000 vials of the deadly SARS virus. Video provided by Newsy
Powered by NewsLook.com
Formerly Conjoined Twins Released From Dallas Hospital

Formerly Conjoined Twins Released From Dallas Hospital

Newsy (Apr. 16, 2014) Conjoined twins Emmett and Owen Ezell were separated by doctors in August. Now, nearly nine months later, they're being released from the hospital. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Now Linked To 121 Deaths

Ebola Outbreak Now Linked To 121 Deaths

Newsy (Apr. 15, 2014) The ebola virus outbreak in West Africa is now linked to 121 deaths. Health officials fear the virus will continue to spread in urban areas. 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