EFN

At a medical meeting in San Antonio this past week, the results of a nine year study on using stents in the carotid arteries to prevent strokes were released and indicated that stents were effective. Called “Crest” for Carotid Revascularization Endarterectomy versus Stenting Trial, the study was conducted in North America.

In the Crest trial, 2502 patients in 100 different hospitals in the United States and Canada were randomly selected to receive either carotid artery surgery or stenting over a nine year period. In most cases the patient’s carotid arteries were more than 70% blocked. Some of the patients had had strokes or mini strokes, and some were asymptomatic. The long term follow-up of these patients which lasted two and a half years and is still on-going showed little difference in the group that had surgery and the group that had stents relative to strokes that should have been prevented.

A European study released just a day earlier had vastly different results with the surgery group doing remarkably better than the stent group. Possible explanations offered for this disparity were that the European study was for symptomatic patients only so they may have had a more advanced artery disease. Also the North American study carefully screened the physicians doing the stenting procedure and included only those who were highly skilled and had a lot of experience.