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Skirting Strokes with StentsSummary: A clinical trial was done to compare endarterectomy with a minimally invasive procedure in which a special stent was inserted in the carotid artery. The stent had an emboli protection device, a filter to prevent clots and other debris from traveling to the brain. It was found the stenting was "not inferior" to endarterectomy. Therefore, the less invasive approach with a stent appears to be an acceptable alternative for people with high-risk carotid-artery stenosis. Expert Comment: "This is a pivotal study....However, the small sample size and the study end points preclude major conclusions.... Physicians, industry sponsors, and regulatory agencies should collectively insist on large-scale, multicenter trials in order to clarify the appropriate role of carotid-artery stenting in patients in different clinical and anatomical subgroups. Such trials have been initiated in North America and Europe." (Richard.Cambria, MD, Mass General Hospital, New England Journal editorial) Our Comment: There is no question that a stent can skirt a stroke but there is more, much more, that remains to be learned about stents in stroke prevention. Barbara K. Hecht,Ph.D.
Frederick Hecht, M.D.
Medical Editors, MedicineNet.com Related Links
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