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New stroke prevention therapy as effective as invasive surgery

CHICAGO Angioplasty and stenting, the same techniques used to clear arteries blocked by heart disease, can also be used on the carotid artery to prevent stroke, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

The results from 180 patients with carotid artery disease showed that angioplasty and stenting were as effective as surgery, with comparable rates of neurologic complications and a similarly low rate of restenosis, or re-narrowing of the artery after treatment.

During the procedure, physicians insert a catheter through a hole in the femoral artery in the groin and thread it through to the carotid artery. A filter is opened over the carotid lesion to protect the brain from any material spreading during the procedure, then a balloon at the tip of the catheter is inflated, widening the artery. To prevent the newly widened artery from closing up again, a wire mesh stent is put in place to hold the artery open.

"Stenting is less invasive than surgery," said Gianluca Piccoli, M.D., an interventional radiologist at the Santa Maria della Misericordia Hospital of Udine in Italy. "Our goal was to find whether you can receive the same or better results as with surgery."

Arteriosclerosis, or hardening of the arteries, is a leading cause of strokes. Fatty deposits building up inside the carotid arteries the two major arteries in the neck that deliver blood and oxygen to the brain can restrict or interrupt blood flow to the brain. The result is stroke. Stroke is the country's third leading cause of death behind heart disease and cancer, according to the American Heart Association.

The preferred method of treating carotid artery disease is surgery, but while carotid surgery is usually successful, it has significant risks, Dr. Piccoli said.

"The surgeon will usually clamp the carotid artery to prevent bleeding, so the flow of blood to the brain
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Contact: Doug Dusik
ddusik@rsna.org
630-590-7762
Radiological Society of North America
1-Dec-2004


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