Linda Searing Special to The Washington Post | Posted: Thursday, May 29, 2008 10:00 pm
Carotid artery disease
Two ways to unclog arteries produce similar results.
THE QUESTION: To open clogged neck arteries, does insertion of a stent to hold open the artery work as well in the long term as conventional surgery, which clears plaque from the artery?
THIS STUDY analyzed data on 260 adults with a severely clogged carotid artery who had been randomly assigned to have open-neck surgery to clean the artery or to undergo a minimally invasive procedure to insert a wire-mesh stent to open it. Stenting included use of a filter to catch debris from the artery wall during the procedure. All participants were given aspirin and heparin, a blood thinner, during the procedures; those who had stenting also took clopidogrel, an anti-clotting drug, beforehand and afterward. Three years later,
9 percent of those in both groups had had a stroke, and there was little difference in the occurrence of such cardiovascular problems as heart attacks or in the number of deaths.
WHO MAY BE AFFECTED? People with a carotid artery that has become narrowed by plaque. This increases the risk that a clot might block the artery, which delivers blood to the brain, and cause a stroke.
CAVEATS All study participants were considered at high risk for complications because of such things as heart or lung disease, previous neck surgeries or being older than 80; the findings may not apply to people at lower risk. Different stents might produce different results. The study was funded by Cordis, which makes the stent and filter used in the study; six of the 12 authors received fees from the company, two were its employees, another invented the stent used in the study and another holds patents related to stenting.