After a recent study looked at patients who had already suffered a mini-stroke due to a blocked neck artery, researchers found that drug treatment was as effective and less risky in the prevention of future stroke, compared to bypass surgery for the blocked artery. These findings will most likely put a halt to most surgical intervention for stroke.
Published in the Journal of the American Medical Association, the study randomly assigned nearly 200 high-risk patients to receive either carotid artery bypass surgery or drug therapy. Thirty days following either method of treatment, the drug therapy actually appeared more effective: During that time, 14 percent of surgical patients had suffered a stroke, compared to only 2 percent of those on the drug treatment. However, after two years, the difference between the two cohorts was essentially nil 23 percent of the drug-treated patients versus 21 percent of those who d undergone surgery had died or had a stroke.
Given these study results, Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine, observed that current guidelines would say there is no indication for pursuing a bypass in these patients ¦medical therapy with anti-clotting drugs, blood pressure and cholesterol-lowering drugs has improved over the years. As the study s lead author pointed out, If you made it through surgery, your risk of having a stroke was 6 percent, but, unfortunately, the risk of having a stroke from surgery was 15 percent.
ACSH s Dr. Gilbert Ross was surprised by the study results, noting that bypass surgery would seem to be a very beneficial method of stroke prevention, yet these data point to the opposite conclusion. Compared to drug therapy, carotid artery bypass surgery really doesn t help as much as one would hope.