By Steven Reinberg HealthDay Reporter
THURSDAY, Oct. 24 (HealthDay News) -- For patients being treated for a blockage in the artery that supplies blood to the head, inserting a stent may raise the risk of stroke more in elderly patients than in younger patients, a large new evidence review finds.
However, death risk was similar for older and younger patients receiving stents. And it was not as high as it was for older patients who underwent a different surgical procedure -- called endarterectomy -- to unblock the clogged artery.
The report was published Oct. 23 in the online edition of JAMA Surgery.
An ongoing debate exists about the best treatment for the condition known as carotid artery atherosclerosis. The issue is whether placing a tiny mesh tube (a stent) to keep the plaque-clogged neck artery open is safer for older patients than endarterectomy -- a surgical procedure to open the artery and remove the plaque.
For the new study, a research team led by Dr. George Antoniou, of the Hellenic Red Cross Hospital in Athens, Greece, reviewed 44 studies that looked at opening the carotid arteries with a carotid endarterectomy or by placing a stent.
These studies included more than 500,000 patients who had a carotid endarterectomy and about 75,000 patients who had a stent placed. In this type of study, called a meta-analysis, researchers try to find common patterns in a number of diverse, but similar studies.
Despite the large number of people included in these studies, Antoniou's group found the quality of the studies was poor -- with each using different criteria in classifying older and younger patients.
The researchers, however, concluded that carotid endarterectomy had similar outcomes in terms of stroke among older and younger patients, but was more often fatal among older patients.
In addition, both procedures seemed to increase the risk of heart attack in older patients. Older patients who had a stent placed, however, had a greater risk of stroke than younger patients, the investigators found.
Link:
Stenting of Neck Arteries Tied to Higher Stroke Risk in Seniors