Stents as Good as Surgery for Blocked Carotid Arteries

A study reporting the ongoing results of a comparison between traditional endarterectomy and less-invasive vascular stenting to clear clogged carotid arteries has found that the results are similar.

Researchers at Loyola University Medical Center (Loyola, Chicago, IL, USA) reported on the nine year results of 14 patients at Loyola participating in the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST), a prospective, randomized, parallel, two-arm, multicenter clinical trial with blinded endpoint evaluation. The study participants were randomly assigned to receive either carotid artery stenting (CAS) or carotid endarterectomy (CEA). The researchers found in that the overall safety and efficacy of the two procedures was largely the same, but also found there were more heart attacks in the surgical group and more strokes in the stenting group. The study results were presented at International Stroke Conference, held during February 2010 in San Antonio (TX, USA).

"Our multidisciplinary team enrolled patients in both arms of this seminal and robust trial,” said coauthor Jose Biller, M.D., of Loyola. "The data obtained at Loyola and other participating centers now will better inform doctors and patients about the relative benefits and risks of endarterectomy and stenting.”

"The treatment strategy should be individualized to each patient, and take into consideration such factors as the patient's age and the type of blockage,” added study coauthor Robert Dieter, M.D. "It also is very important to consider how much experience the hospital and the physician have in performing each procedure.”

The stent used in the CREST trial is the Acculink Carotid Stent System, an elastic-like metal scaffold that is expanded inside a carotid artery to hold the vessel open. The stent is used in conjunction with the RX Accunet Embolic Protection System--an umbrella-like device that expands above the narrowed portion of the carotid artery--designed to capture embolic material that could break off from the narrowed area in the carotid artery, while still allowing blood to flow through the vessel during the procedure. Both the Acculink Carotid Stent System and the RX Accunet Embolic Protection System are products of Abbott (Abbott Park, IL, USA).

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Loyola University Medical Center
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