Surgery better than angioplasty in avoiding stroke: Study

Two new studies substantiate many previous researches which have shown that patients who undergo balloon angioplasty to clean the blocked neck arteries show poor results thereafter.

However, there is still no surety as to which of the two procedures is the best option.

Stroke researcher Peter M. Rothwell, MD, PhD, said, “Taking all the studies together, the risk of stroke is now clearly higher with angioplasty.”

He further added, “What these two (new) papers now also show is that the long-term outcome is also worse with angioplasty. This is therefore a double-blow for angioplasty.”

Both the new studies have been done by an international team of researchers. The studies are significant because they include the longest follow-up of patients who have undergone surgery or angioplasty for coronary artery disease.

First study’s findings
For the first study, 504 patients were taken into account. Out of these, 251 patients had surgery and 253 had undergone angioplasty. All these people were followed for a period of 11 years.

After eight years, it was discovered that 11.3 percent angioplasty patients suffered a stroke, while the number stood at 8.6 percent for surgery patients.

Also, more minor strokes were observed in angioplasty group within the first 30 days of having the procedure, as compared to the surgery group.

Second study on plaque pile-up
Ultrasound imaging was utilized in the second study. The researchers looked up for plaque pile-up in the carotid arteries of 213 patients following surgery and 200 following angioplasty.

After a follow-up of five years, it was found that 31 percent angioplasty patients had severe artery blockage as compared to only 10 percent surgery patients.

Martin M. Brown, MD, was quoted as saying, “Patients who had angioplasty with stents had a lower risk of plaque recurrence than those who had angioplasty alone.

“The trials make it clear that surgery is the best option, but it is important to understand that the difference is not that great. Patients who can’t have surgery or don’t want it are still likely to do well.”

Fatty plaque causes strokes
One of the main causes of a stroke is the narrowing of the carotid artery due to accumulation of fatty plaque. There are two options available for removing this plaque, i.e., by surgery or balloon angioplasty.

Nowadays, balloon angioplasty is done with stenting, where a wire mesh stent is inserted so as to keep the artery open. Balloon angioplasty involves inflating a tiny balloon threaded up to the neck through a narrow catheter placed in the groin artery.