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Carotid Stenting Safe Alternative to Surgery

Propping open this vital vessel can help prevent strokes, experts say

TUESDAY, March 14, 2006 (HealthDay News) -- Placing a vessel-opening stent in the carotid artery is safe for people who have blocked carotid arteries but no symptoms and, due to other medical conditions, can't have surgery to clear the blockages, a new study finds.

Carotid artery stenting combines balloon angioplasty and a stent implant to clear buildups of fat and cholesterol and reopen the artery, which is the major supplier of blood to the brain. Blocked carotid arteries can decrease blood flow and increase the risk of stroke.

The findings were presented Tuesday the American College of Cardiology annual meeting, in Atlanta.

Currently, the U.S. Center for Medicare and Medicaid does not cover carotid stenting for people with carotid artery blockage who have no symptoms, such as weakness, paralysis, visual problems or speech difficulties.

The current study involved 2,500 patients treated at 188 medical centers across the United States. The patients were all treated with Guidant's RX ACCULINK Carotid Stent System with RX ACCUNET Embolic Protection System.

Among asymptomatic patients, the rate of major complications (death, stroke or heart attack) within 30 days after the stenting procedure was 5.7 percent. That's lower than the rate found in other studies of similar patients who had surgery to clear blocked carotid arteries.

"The scope of this landmark trial provides us with a clear picture of the patients who benefit the most from carotid artery stenting. We hope these results will expand coverage to asymptomatic patients who are risk candidates for surgery," principal investigator Dr. William Gray, an associate professor of clinical medicine at Columbia University Medical Center in New York City, said in a prepared statement.

Gray is director of endovascular services at the Center for Interventional Vascular Therapy at New York-Presbyterian Hospital/Columbia and the Cardiovascular Research Foundation.

The study also found that younger patients had better outcomes. Stroke, death or heart attack occurred in 8.9 percent of patients over age 80, compared to 4.8 percent for patients under age 80.

More information

The Society for Vascular Surgery has more about carotid artery disease.

SOURCE: Columbia University Medical Center, news release, March 14, 2006
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