Help for carotid artery disease catch-22

Dec. 13, 2010 at 9:27 PM
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DALLAS, Dec. 13 (UPI) -- Untreated carotid disease can cause a stroke and artery surgery to fix it can too, but U.S. doctors say there are clues to avoid this medical catch-22.

Researchers at the University of Texas Southwestern Medical Center in Dallas say patients with untreated carotid artery disease -- clot-causing material on the walls of the arteries of the neck -- are more likely to suffer strokes. However, sometimes the surgery correcting the condition can also cause a stroke.

"It may take a thief to catch a thief, but physicians don't want to cause stroke while trying to prevent stroke, so being able to carefully weigh an individual's benefits and risk from carotid surgery is critically important," Dr. Ethan Halm says in a statement.

The study, published in the journal Stroke, lists eight factors that signal patients may be among those most at risk for post-surgical death -- being female, a minority, severely disabled, having a history of stroke, having arteries narrowed more than 50 percent, coronary artery disease, congestive heart failure or valvular heart disease.

"For patients with several other medical risk factors, the upfront risk of surgery can outweigh any potential long-term benefits," Halm says.

Halm, the senior author, and colleagues reviewed outcomes of 9,308 carotid surgeries performed on elderly patients in 167 hospitals. Within 30 days of surgery, there were 55 deaths and 165 strokes, the study says.

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