Stents, surgery equally durable, safe for reducing stroke risk

The results mean doctors can choose a treatment option based on ease, comfort and best fit for a patient's individual medical condition.
By Stephen Feller  |  Feb. 19, 2016 at 4:08 PM
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JACKSONVILLE, Fla., Feb. 19 (UPI) -- The second part of long-term study on the safety and efficacy of stents versus surgery to prevent strokes in patients with blocked arteries found no difference between the two, according to the new research.

The ten-year study measured the long-term effects of each treatment, with the conclusion of the second affirming doctors can choose the treatment best fit for patients without worrying that one is better than the other.

The two studies were conducted at 117 medical centers in the United States and Canada, and coordinated by the Mayo Clinic, Rutgers University and the University of Alabama Birmingham.

Phase 1 of the study, the Asymptomatic Carotid Trial, or ACT I, was conducted over five years and found stents and surgery were equally safe. Fewer strokes were recorded among patients who underwent surgery and those who received stents had fewer heart attacks.

"This second phase completes a story, and the results are very encouraging," Dr. Thomas Brott, a neurologist at the Mayo Clinic, said in a press release. "We have two safe procedures. We know now that they are very effective in the long run. Now the patient and the physician have the option to select surgery or stenting, based on that individual patient's medical condition and preferences."

Phase 2 of the trial, the ten-year Carotid Revascularization Endarterectomy versus Stenting Trial, or CREST, published in the New England Journal of Medicine, included 2,502 participants who received either stents or had surgery to clear arterial clogging and were followed up with every six months for 10 years.

There was no significant difference between the two groups: 11.8 percent of patients with stents and 9.9 percent of the surgery group had a heart attack in the decade after their procedure; and 6.9 percent of the stent group and 5.6 percent of the surgery group had a stroke in the following ten years.

On top of the relatively low risk for either health event, both groups' arteries re-narrowed at the same rate of about 1 percent per year.

"This very low rate shows these two procedures are safe and are also very durable in preventing stroke," Brott said. "Because Medicare-age patients with carotid narrowing are living longer, the durability of stenting and surgery will be reassuring to the patients and their families."

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