equally successful surgery and stent for stroke prevention
patients who suffer a stroke due to a narrowing of the carotid artery, are at high risk of another stroke. Many of these second-strokes can be avoided if the constrictions are fixed in time. This is now possible by two methods: If endarterectomy is the surgical removal of deposits. In a catheter treatment, however, is under local anesthesia, a stent, a stent that is used. A new vascular closure should be avoided. For years, doctors discuss which of the two methods is more successful. New Study Results show now that the chances of success are two methods in the long run the same. However, there are big differences in the complication rates of the various treatment centers. The German Stroke Society recommends therefore concerned to be informed prior to surgery on complication rates of the respective center.
calcifications in the carotid artery are a major cause of stroke. If such restriction has led to a stroke are at high risk of another stroke. About every seventh patient, who suffered a stroke due to a narrowing of the carotid artery is threatening, the same year a fresh stroke. If we eliminate the restriction, shall It is only once every twenty-fifth patient, explains Professor Martin Grond, MD, a board member of the German Stroke Society, and chief doctor at the hospital victories. An arterial occlusion can be corrected both operationally and minimally invasive: Vascular surgeons can enucleated with an operation, the calcifications and fat deposits. In addition, since some years the opportunity to address the bottleneck without surgery, minimally invasive, the patient receives just one local anesthetic. The doctor then performs a balloon catheter into the vessel and expands the narrowed point. Subsequently, a stent is used. He should avoid a second vascular closure.
In several studies have
examined physicians success and complication of surgery and stenting. The follow-up results of three large comparative studies now show that both methods have in the long run no significant differences. So the French EVA-3S study has shown that four years after treatment approximately equal in both groups many new strokes occurred. In the same direction, the two-year results in Germany, Austria and Switzerland conducted SPACE study, and the three-year results of the American SAPPHIRE study.
medium and long term, both methods achieve similar results, says Professor Grond the study data together. However, it has also been shown that the differences in the complication rates of the various treatment centers is very high, the expert on. Patients should be aware of this when selecting an intervention center. An aid to decision can offer, according Grond the complication in the quality reports of the facilities. Each intervention center also should publish a register of complications, so that patients can obtain at first glance an overview. It is particularly important that this be done in collaboration with a neurologist. In this context, however, important to mention that this knowledge only for narrowing of the carotid artery is already a permanent or volatile stroke, called a transient ischemic attack (TIA), have inflicted. If one finds in an investigation by chance, a narrowing of the carotid artery, this must not necessarily be treated by stent or surgery, but you also do drugs, so Grond.
quote and source: German Stroke Society
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