A decade-long study was conducted at various medical facilities across the United States to check the impact of stents and surgery on heart patients. The study team recorded the long-term effects of both treatments, concluding that doctors can go for any of the treatment options best suitable for patients. The study team found that both stent and surgery had similar positive results and doctors should consider whatever is best for individual patients.
As per the latest research, the second innings of a long-term study on the safety and effectiveness of stents in comparison to surgery to prevent strokes in patients having blocked arteries has discovered no difference between both.
Both the studies were conducted at 117 medical centers in the United States and Canada and were teamwork of Rutgers University, the Mayo Clinic, and the University of Alabama Birmingham.
The Asymptomatic Carotid Trial, or ACT I, which was Phase 1 of the study, was carried out over five years and discovered that stents and surgery possess equal safety. Lower risk of stroke was noted in patients who went through surgery and the ones who got stents had fewer heart attacks.
In a press release, Dr. Thomas Brott, a neurologist at the Mayo Clinic, said, “This second phase completes the story, and results are very encouraging. We have two safe procedures and know how they are effective in the long run. Now patient and physician have the option to select surgery or stenting, based on that individual patient’s medical condition and preferences”.
The decade-long Carotid Revascularization Endarterectomy versus Stenting Trial or CREST was Phase 2 of the trial. Published in the New England Journal of Medicine, it included 2,502 participants who got either stent or underwent surgery to clear arterial clogging. The participants were tracked every six months for 10 years.
No major difference was found between both the groups. The statistics were 11.8% of patients who received stents and 9.9% of the surgery group suffered a heart attack in the ten years after their procedure. Besides, 6.9% of the stent group and 5.6% who underwent surgery suffered a stroke in the following decade.
Walter Koroshetz, M.D., director of the National Institute of Neurological Disorders and Stroke, also noted that “the stroke rate in CREST was less than half of what was seen in similar studies from the late 1900s, which reinforces the benefits of modern medical control of vascular risk factors.”
In 2010, phase one of CREST found stenting and surgery to be equally safe procedures, with fewer strokes among those who had surgery, and fewer heart attacks among those who received stents. Those results also were published in the New England Journal of Medicine.
The study found the risk for stroke after either stenting or surgery (endarterectomy) was about 7 percent. The 10-year comparisons of restenosis (re-narrowing of the carotid artery) were low for both stenting and surgery – about 1 percent per year. The equal benefit was found for older and younger individuals, men and women, patients who had previously had a stroke, and those who had not.
“This very low rate shows these two procedures are safe and are also very durable in preventing stroke,” says CREST principal investigator Thomas G. Brott, M.D., a neurologist, and the Eugene and Marcia Applebaum Professor of Neurosciences on Mayo Clinic’s campus in Florida.