’Risky’ stroke prevention procedure may be safe in some patients

A major study published today in the Lancet Neurology , funded by the Medical Research Council (MRC) and the Stroke Association, found that stenting in the carotid artery (in the neck) is as safe as carotid artery surgery at reducing stroke risk in some patients. The research, which was part of the International Carotid Stenting Study (ICSS), reveals that stenting is equally as safe as surgery in patients who show few signs of changes to brain tissue (known as white matter lesions) in a brain scan. However, patients whose brain scans do reveal changes to brain tissue, potentially caused by aging or conditions such as high blood pressure, should not be treated by stenting. The study, which was run from UCL, highlights the importance of carrying out brain scans in patients undergoing either procedure in order to determine which is most suitable. One in five strokes are caused by narrowing of the carotid arteries due to a build-up of fatty deposits on the artery walls. However, the risk of stroke can be reduced by surgery to clean out the deposits or through stenting to widen the artery. Both procedures carry risks and in a minority of cases they can cause a stroke at the time of treatment.