Carotid Artery Surgery May Prevent Stroke
WebMD News Archive
Surgery vs. Watchful Waiting continued...
"The reduction of about four-fifths in
carotid [artery-related] stroke is so extreme that it can be reasonably"
advised for patients who have severe carotid artery blockages, writes
Although wider use of cholesterol-lowering
statin drugs will somewhat reduce the overall risk of stroke, the remaining
risk "should be avoidable by successful surgery," she writes.
Unsuccessful surgery, however, can do much harm if it's done by an
inexperienced or unskilled surgeon.
Good use of drug therapy should lower any
remaining risks -- both after surgery and if surgery is not performed, she
Carotid surgery is best for patients under
age 74, writes Halliday. Half of all older patients die within five years from
unrelated causes. She will continue following patients in her study for a full
Get a Good Surgeon
In a commentary in The Lancet, one
surgeon points out that choosing your surgeon carefully is
"Patients must recognize that with good
medical care, they face only a 2% annual stroke rate, which falls below 1%
after a successful carotid artery [surgery]," writes H.J M. Barnett, MD, of
Ontario, Canada. But if the surgery is performed under less than optimal
conditions, the benefits "could be obliterated."
He advises checking the surgeon's track
record, which should be readily available from the referring physician. Any
hospital should require an independent audit of surgical death rates and ensure
their ready availability, Barnett writes. Having a less-than-skilled surgeon
"quickly casts [carotid surgery] into the list of 'risk factors for
stroke,'" he concludes.