Stents can make stroke-preventing surgery safer

June 23, 2001

NEW YORK, Jun 20 (Reuters Health) - Implanting stents into key arteries

leading to the brain can be a safe and effective way to prevent

complications that can occur in the immediate aftermath of an

artery-clearing operation, researchers report.

The operation, carotid endarterectomy, is a stroke-preventing procedure that

involves removing fatty plaque from inside the carotid arteries in the neck

that lead to the brain. According to researchers, 20% to 30% of strokes

occur when a carotid artery becomes blocked. While carotid endarterectomy

has been shown to reduce the risk of stroke, up to 9% of patients suffer

strokes during or after the procedure.

To investigate whether stents--tiny scaffold-like structures used to prop

open blocked arteries--could reduce carotid endarterectomy complications,

the researchers studied 18 patients who had neurological complications after

the surgery. Thirteen had stents implanted in their arteries to treat the

complications, while five had surgery without stent implantation.

Results of the study, published in the June 15th issue of The Journal of the

American College of Cardiology, show that 11 of the patients with stents, or

about 85%, experienced a complete remission of their neurological symptoms,

which were mainly mini-strokes called transient ischemic attacks.

In comparison, only one patient in the other group recovered completely

while the remaining four patients (80%) did not have any neurological

recovery, the report indicates.

" The main finding of this study was that stent implantation seems to be more

effective than surgical re-exploration in the treatment of perioperative

stroke, " Dr. Angelo Anzuini of IRCCS San Raffaele Hospital in Milan, Italy,

and colleagues, conclude.

They describe the findings as " encouraging " but call for additional research

on larger groups of patients.

SOURCE: Journal of the American College of Cardiology 2001;37:2074-2079.

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