Stroke prevention surgery is being used in a more appropriate way

Reported by Susan Aldridge, PhD, medical journalist

There has been a fall in the number of people undergoing carotid endarterectomy for the wrong reasons in the last two decades.
Carotid endarterectomy is a form of stroke prevention surgery which involves removing plaque from the arteries serving the brain. It is not without risk, which is why it is important that it is used only on those patients who stand to gain real benefit. Research has been carried out in the last 20 or so years which has revealed when carotid endarterectomy is most appropriate and the evidence has now been reviewed by the New York Carotid Artery Surgery Study.

They looked at appropriateness of nearly 10,000 carotid endarterectomies carried out on elderly patients in New York State. This showed that while 32 per cent of carotid endarterectomies were inappropriate in 1981, the figure has now fallen to 8.6 per cent. The main problem now is that carotid endarterectomy is too often carried out on individuals who have no symptoms from their blocked carotid arteries and who have other major medical problems. The risk of death or stroke from the carotid endarterectomy itself is double the average in this group. These new findings can now be used by doctors to help decide which of their patients have most to gain from carotid endarterectomy.

Source
Neurology 16th January 2007