DALLAS, Sept. 1 -- A follow-up analysis confirms that surgery to unclog severely blocked neck arteries has long-term benefits for preventing strokes, researchers report in this month's Stroke: Journal of the American Heart Association.
In 1991, the North American Symptomatic Carotid Endarterectomy Trial (NASCET) showed that surgery was beneficial in people with symptoms such as numbness on one side of the face, trouble speaking, dizziness, or a sudden severe headache as a result of carotid artery blockages of 70 percent or more. Recent analysis of the data revealed that after three years, there was nearly 20 percent reduction for stroke in patients who had undergone surgery versus those who received non-surgical treatment.
"This operation continues to be worthwhile," says Henry J.M. Barnett, M.D., professor of neurology at the University of Western Ontario in Canada, and a NASCET researcher. "Even after a decade, patients who underwent surgery still have a high level of benefit compared to people who were only treated medically."
In a second component of the research, physicians involved in the trial had the unique opportunity to compare the outcomes of the patients who underwent surgery to the patients who initially received non-surgical treatment but had surgery later -- once researchers discovered the clear benefit of surgery. Carotid endarterectomy, the surgical procedure to remove plaque from the carotid artery before it can cause a stroke, proved durable in the long term and reduced the risk of stroke. There was moderate benefit in the patients with delayed endarterectomy.
Patients who did not have surgery had a greater amount of blockage in the neck artery. However, the longer these patients remained symptom-free, the lower their risk of stroke.
NR00-1168 (Stroke/Barnett)
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