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Carotid Stenosis Treatments Similar in High-Risk Patients

Protected carotid stenting compared to endarterectomy

WEDNESDAY, April 9 (HealthDay News) -- Carotid artery stenting with an emboli-protection device and carotid endarterectomy result in similar three-year outcomes in high-risk patients with carotid artery stenosis, according to research published April 10 in the New England Journal of Medicine.

Hitinder S. Gurm, M.D., of the University of Michigan in Ann Arbor, and colleagues report long-term results from the SAPPHIRE trial, which compared carotid artery stenting plus use of an emboli-protection device to endarterectomy in 334 patients at high surgical risk with symptomatic carotid artery stenosis of at least 50 percent or asymptomatic stenosis of at least 80 percent.

At three-year follow-up, the incidence of the pre-specified secondary endpoint -- composite death, stroke or myocardial infarction within 30 days post-procedure, or death or ipsilateral stroke one month or more post-procedure -- occurred in 24.6 percent of patients treated with protected stenting and 26.9 percent of patients treated with endarterectomy, which is a non-significant difference, the researchers report.

"Our data are specific to patients who are at high surgical risk, and they provide no insight into outcomes of treatment of a carotid artery stenosis in patients at low-to-moderate risk," the authors caution.

This study was funded by Cordis. Gurm served as an inventor on patents related to carotid artery stenting, while a second co-author was the inventor of the emboli-protection device used in the trial. Several co-authors served as consultants to pharmaceutical and medical technology firms.

Abstract
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