Study Shows Stent is a Good Alternative to Bypass
The less invasive process of stenting is also as effective as the widely followed surgical method to clear any blockage in the neck arteries for the prevention of strokes, as revealed by the largest comparative study.
Stenting is the procedure by which flexible tubes are fixed to open up the blockage inside the artery for the clearing of any plaque-clog in the coronary arteries that causes the heart attack. This procedure is also being used to open up any blockage in the neck arteries. However, the surgical procedure known as carotid endarterectomy is still the widely followed method.
Researcher Wayne Clark, MD, of Oregon Health & Science University opines, “This has presented us with two options and one of it should be chosen depending upon the person’s health, age, and preference.”
The research study placed at the American Stroke Association’s (ASA) International Stroke Conference revealed that for patients who had undergone surgery, the incidence of heart attack was a little bit more patients who had stents faced slightly more strokes, in the weeks after the surgery.
“However, there was no substantial difference in the nature of strokes or heart attack after an average time of 25 years,” Clarke reveals. “The occurrence of stroke, heart attack, or death was only 2 percent in both the groups. This is the lowest rate of fatalities in any ‘stenting vis-à-vis surgery’ stroke trial,” He said.
Thomas Brott, MD, of the Mayo Clinic in Jacksonville, the lead researcher said, “We expected stents to be more suitable for older patients due to its less invasive procedure. But the study showed that while the stents were more beneficial for patients under the age of 70, surgery was better for patients above 70 years.”
The National Institute of Neurological Disorders and Stroke with supplemental funding from stent maker Abbott Vascular funded the research.
Stenting vs. Surgery: Trials in Europe show inconclusive results.
The result of the research study announced immediately after the European research findings published in Lancet, an online journal claimed that patients who had stents suffered from a higher rate of heart attack, stroke, and death, as compared to surgery.
The University of Miami’s Ralph Sacco, MD, president-elect of the American Heart Association attributes this discrepancy to the selection of the patients. To highlight this, he observed, “While the European study covered only patients with symptoms like vision problem and swishing in the ears due to neck blockages, the North American study included patients with or without these symptoms.”
“Furthermore, for the North American studies, the doctors were more experienced.” Brott opines. “The stents used were also different. While in the case of the European trials, any approved stents were used, only Abbott’s Acculink Carotid Stent System was used during the North American trials,” Clark said.
Stents are as Effective as Surgery
Strokes are reported to be third amongst the leading causes of death in the United States, as around 800,000 Americans suffer from it and almost 140,000 succumb to it.
About 2,502 patients in more than 100 hospitals in the US and Canada, half of whom received stents and the rest surgery were included in the recent study known as CREST.
In the first month after the procedure, 2.3 % of patients of surgery patients suffered a heart attack, as compared to 1.1% of stents patients and 4.1% of stents of patients suffered a stroke as compared to patients who had undergone surgeries.
The quality of life of the patients who had a heart attack was reportedly better than those who suffered from strokes. Within two and a half years, 2 percent of patients with stents faced heart attack, stroke, or death. This was 2.4% in case-patients who had undergone surgery. But this difference is very minor and could be due to chance.
In the European trial, of the 1713 patients, 5.2% of patients, who underwent surgery had a heart attack, stroke, or death as compared to 8.5% of stent patients.