Study: stents as effective as surgery

BUFFALO, N.Y. (WIVB) - For people with clogged neck arteries, a new study finds that tiny mesh tubes known as stents do just as good a job of restoring blood flow to the brain as surgery does.

This patient has just had a procedure that will prevent her from having a stroke. One of the carotid arteries in her neck that had been clogged by atherosclerosis. Here's what a normal carotid looks like on an angiogram: a nice, straight, smooth black column of blood flow. But atherosclerosis makes the artery look like this: narrow and irregular, impeding blood flow to the brain.

It could be reopened with surgery, but now, many patients receive stents instead, tiny mesh tubes that open the arteries from the inside. But, which is better? A recent report based on 2,500 patients showed that they are essentially equivalent.

Dr. Elad Levy of UB Neurosurgery said, "It basically showed that one procedure is not necessarily better than the other. They had similar outcomes, similar benefits, and roughly similar stroke rates and heart attack rates."

Dr. Levy and his colleagues at UB Neurosurgery participated in the study. In fact, they were among the first in the country to use carotid stents.

"Many, many Buffalo patients were enrolled in the study and basically helped come to the conclusion that both these procedures are excellent. One procedure is not better than the other. The key is understanding which patient benefits from which procedure," explained Dr. Levy.

This patient received a stent. You can see it here on her x-ray. And the result was a well-opened artery. Surgery and stenting may be equivalent, but the decision is tailored to the patient.

Dr. Levy said, "I don't think one is better than the other, but there is always one that is better than the other for each individual patient."

Re-opening the artery in the neck, regardless of how it's done, cuts the risk of a stroke just about in half.

Question: How do you find out if you have a clogged artery that needs to be opened?

Answer: Some people have symptoms that mimic a stroke, but the artery can be significantly narrowed without causing symptoms, and it might be discovered as part of a routine physical exam. Even if someone has had no symptoms, even in those people, opening the artery cuts the risk of stroke in half.