People at high risk of having a stroke are half as likely to have a stroke or die following surgery to repair damage to an artery in the neck, rather than “stenting” treatment, according to UCL research published in the Lancet.
These findings emerged from a major trial carried out at the UCL Institute of Neurology, which was funded by the Medical Research Council and The Stroke Association. The results of the study showed that the rate of stroke or death within 30 days of treatment for patients was 7.4% in those treated by stenting, compared with 3.4% in those treated by surgery. Until now there has not been any conclusive proof over which method was safer and offered the lower risk of complications. Both groups involved in this study, involving over 1,700 patients, had a very low rate of heart attack of less than 0.5%. Patients were selected who had already had a “mini stroke” and were therefore at a much higher risk of going on to have further strokes. Part of the International Carotid Stenting Study, the trial aims to compare two forms of treatment designed to lower a person’s risk of stroke, which is significantly increased by the narrowing of the carotid artery in the neck and caused by cholesterol. Martin Brown, professor of stroke medicine at the UCL Institute of Neurology, said: “The results of this trial demonstrate convincingly, for the first time, that surgery is a safer option for patients than stenting when dealing with patients at risk of stroke. As a result, we believe that surgery should therefore be the treatment of choice in these circumstances. However, there will still be a role for carotid stenting, particularly for those who are not suitable candidates to undergo surgery.”
