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Stenting and Endarterectomy Have Similar Results

After two years both artery stenosis treatments have similar recurrence rates

MONDAY, Sept. 8 (HealthDay News) -- Carotid endarterectomy and stent-protected angioplasty produce similar results at the two-year mark when used to treat severe symptomatic carotid artery stenosis, according to research published online Sept. 6 in The Lancet Neurology.

Hans-Henning Eckstein, M.D., of the Technical University of Munich in Munich, Germany, and colleagues conducted a study of 1,214 patients with severe symptomatic carotid artery stenosis, of whom 613 were randomized to carotid angioplasty with stenting and 601 were treated with carotid endarterectomy.

Two years after surgery there was no difference between the two groups in incidence of ipsilateral ischemic stroke, periprocedural stroke or death, the researchers report. There was a significantly higher frequency of recurrent stenosis of more than 70 percent in the carotid artery stenting group versus the carotid endarterectomy group, but only two of these cases resulted in neurological problems, the investigators found.

"Patients who were successfully treated with stent-protected angioplasty had a similar low risk of secondary cerebrovascular events as patients who were treated with endarterectomy, indicative of the similar preventive ability of endarterectomy and carotid angioplasty with stenting," the authors write. "To assess the long-term effects, and particularly the effect of restenosis, most investigators agreed to collect follow-up data for up to five years after the initial study protocol had ended."

The study was funded by Boston Scientific, Guidant, and Sanofi-Aventis. Several of the study authors report financial relationships with the pharmaceutical industry.

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