Carotid Stent Riskier Than Surgery

Carotid artery stenting has higher risk of stroke or dying

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Among patients with blocked arteries in their neck, surgery may be the way to go. A surgical procedure to remove plaque build up in the neck's carotid artery has been found to have fewer serious risks than a less-invasive stent.

Carotid artery stenting to prop open the blocked artery has been found to be associated with an increased risk of stroke or dying.

"Ask your cardiologist which procedure would be most appropriate."

Barbara Rantner, MD, PhD, from the department of vascular surgery at Innsbruck Medical University in Austria, also found that the risk was highest within the first week after a patient received a stent.

The effect was found independent of a patient's age.

During the research carried out for the Carotid Stenting Trialists’ Collaboration, researchers tracked 2,839 patients with narrowed or blocked carotid arteries who received either a stent or surgery for 30 days.

The participants were pooled from an analysis of data from individual patients randomized in the Endarterectomy vs. Angioplasty in Patients With Symptomatic Severe Carotid Stenosis trial (EVA-3S), the Stent-Protected Angioplasty vs. Carotid Endarterectomy Trial and the International Carotid Stenting Study.

Researchers found that a stroke or death occurred significantly more frequently in patients that received stents, with 110 of 1,434 stent patients suffering a stroke or dying as compared to 54 of 1,405 surgery patients.

Those that received surgery within seven days of symptoms had the lowest risk of stroke or death, with only three deaths reported per 106 patients.

Stent patients who were treated within seven days were found to have a 9 percent risk of stroke or dying, compared to an 8 percent risk if they received treatment 8 to 30 days after symptoms. Carotid artery surgery after eight days or more carried a risk of stroke or dying of up to 4 percent.

The research was presented today at the Vascular Annual Meeting presented by the Society for Vascular Surgery.

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Review Date: 
June 5, 2012
Last Updated:
June 9, 2012