Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Vascular Surgeons Ask, What's Next for Carotid Artery Stenting?

16.01.2008
A procedure called carotid artery stenting (CAS) has emerged as a minimally invasive alternative to surgery, called carotid endarterectomy (CEA), for patients with dangerous narrowing of the arteries supplying blood to the brain. However, questions remain about the best uses of this procedure—especially whether it is an appropriate alternative to surgery for "low-risk" patients, according to a special article in the January/February issue of Annals of Vascular Surgery.

"Currently, the choice of CEA versus CAS in individual patients is based more on individual practitioner experience than on clear evidence-derived guidelines," according to the new article by Drs. Philip P. Goodney and Richard J. Powell of Dartmouth-Hitchcock Medical Center, Lebanon, N.H. "Nonetheless, the popularity of less-invasive therapy combined with marketing of new CAS systems has increased the utilization of CAS."

Drs. Goodney and Powell review and summarize the research evidence on CAS to prevent stroke in patients with narrowing (stenosis) of the carotid arteries. In the CAS procedure, an expandable mesh device called a stent is placed to increase blood flow through the area of stenosis.

Recently, several randomized controlled trials—the strongest category of scientific evidence—have directly compared the results of CAS and CEA. It has now been fairly well established that CAS and CEA yield comparable results in "high-risk" patients.

However, debate continues as to the role of CAS in the much larger group of "low-risk" patients. Some studies suggest that CAS and CEA produce similar results, but others have found a lower rate of serious complications and death in patients undergoing surgery.

Drs. Goodney and Powell note several limitations of the research that make it difficult to compare results between trials. Studies being conducted now will help to clarify the relative performance of the two techniques in both high-risk and low-risk patients. A key question will be whether CAS or CEA is the better choice for patients considered high-risk because of medical conditions.

Other issues that will need to be worked through include refinements in the design of CAS systems and the role of detailed imaging studies in guiding treatment decisions. "Ongoing randomized trials will help determine optimal revascularization strategies in the future," the authors conclude.

Jayne Dawkins | alfa
Further information:
http://www.elsevier.com/

More articles from Health and Medicine:

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht On track to heal leukaemia
18.01.2017 | Universitätsspital Bern

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

New Study Will Help Find the Best Locations for Thermal Power Stations in Iceland

19.01.2017 | Earth Sciences

Not of Divided Mind

19.01.2017 | Life Sciences

Molecule flash mob

19.01.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>