Stents good for unclogging carotid arteries

A significant trial has found that stents are as good as surgery for unclogging carotid arteries.

The study found that the safety and efficacy of both procedures are roughly equal. The researchers' multidisciplinary team enrolled patients in both arms of this seminal and robust trial.

Carotid arteries on each side of the neck supply blood to the brain. As a patient ages, plaque can build up, causing the artery to stiffen and narrow. A patient can suffer a stroke if the artery becomes completely blocked. Or, bits of plaque can break off and travel to the brain and cause a mini stroke called a transient ischemic attack (TIA). The traditional gold standard treatment is an endartectomy. A surgeon peels out the plaque deposit by removing the inner lining of the clogged artery. In the newer stenting procedure, a surgeon uses a catheter to deploy a stent (mesh tube). The stent expands inside the artery to increase blood flow.

CREST followed 2,502 participants, who were randomly assigned to receive an endarterectomy or a stenting. The overall safety and efficacy of the two procedures was largely the same. However, there were more heart attacks in the surgical group and more strokes in the stenting group.

Both procedures are very safe and effective. Depending on a patient's age and medical condition, one procedure can have an advantage over the other.