PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Stenting safe and effective for long-term stroke prevention

Using stents to keep neck arteries open is just as effective as invasive neck surgery for long-term prevention of fatal and disabling strokes

2014-10-14
(Press-News.org) Using stents to keep neck arteries open is just as effective as invasive neck surgery for long-term prevention of fatal and disabling strokes, reports an international trial led by UCL (University College London) funded by the Medical Research Council and Stroke Association.

The research paper, published today in the Lancet, was authored by researchers from UCL, Basel University, Switzerland, the London School of Hygiene & Tropical Medicine, the University Medical Center Utrecht, Netherlands, Sheffield Teaching Hospitals NHS Foundation Trust, and Newcastle University.

The brain's blood supply comes from the carotid arteries, two large blood vessels that run through the neck. Carotid artery disease occurs when cholesterol and fatty deposits build up in these arteries, restricting blood flow and increasing the risk of stroke.

In the UK, carotid artery disease is most commonly treated by an invasive surgical procedure called endarterectomy. Patients are put under general or local anaesthetic and surgeons cut open the affected artery to remove the build-up and then sew the wound up. The operation leaves a scar on the neck and can lead to heart attack, short-term facial paralysis from nerve damage, and bleeding, which can prolong hospital stays.

Stenting is an alternative procedure in which a small mesh cylinder, a 'stent', is used to keep the artery open. This is inserted under local anaesthetic through a small nick in the groin and fed up to the neck using a thin wire. The procedure is less invasive, causing only minor bruising in the groin, no risk of nerve damage and a lower heart attack risk than endarterectomy.

The study followed 1,713 patients with carotid artery disease, of whom 855 were assigned to stenting and 858 to endarterectomy, for up to 10 years. The median follow-up was 4.2 years. Both techniques were found to be equally good at preventing fatal and disabling strokes, but stented patients were slightly more likely to have minor strokes without long-term effects. The risk of any stroke in five years was 15.2% in the stenting group compared to 9.4% in the endarterectomy group, but the additional strokes were minor and had no impact on long-term quality of life.

"At the moment, stenting is not widely used in the UK due to historical uncertainty over its long-term effectiveness," says study leader Professor Martin Brown from the UCL Institute of Neurology. "However, we have now shown that stenting is just as good as endarterectomy for preventing fatal and disabling strokes. We have also shown that the risk of stroke during the procedure is no higher for stenting than for endarterectomy in younger patients. The risks of each procedure are different and will vary depending on the patient, but stenting should be offered as an option to many more patients under the age of 70.

"One of the issues is that there are not many centres in this country that currently offer stenting as an option so the patient choice is not there. Now that we know stenting is effective in the long term, more staff should be trained to carry out the procedure and gain experience. Otherwise there is a vicious cycle where nobody at a centre has stenting experience so patients are only offered endarterectomy and staff cannot learn or observe the procedure. In other countries, stenting is more widespread and the safety of the procedure improves as staff gain experience."

Dr Shamim Quadir, Research Communications Manager at the Stroke Association, said: "A transient ischaemic attack, also known as a mini-stroke, can be a warning sign that someone has carotid artery stenosis, and is at risk of having a major stroke. Preventative procedures to treat such carotid artery stenosis are therefore crucial. "Carotid endarterectomy is a common, yet invasive surgery used to treat carotid artery stenosis, and is widely used throughout the UK. Previously, far less was known about the long-term effectiveness of stenting as an alternative procedure.

"These latest research findings suggest that overall, stenting is just as safe, and equally effective for the long-term prevention of fatal and disabling strokes. Both procedures carry their own risks, and these will need to be considered for each individual patient.

"This research provides a vital step in providing another viable option which will help people significantly reduce their stroke risk."

INFORMATION:



ELSE PRESS RELEASES FROM THIS DATE:

Oral health problems in elite athletes 'must be addressed'

2014-10-14
Poor oral health affecting athletes' general health and performance shows 'no signs of improvement' and must be remedied, say a group of UCL-led health experts and sporting bodies. In a consensus statement published in the British Journal of Sports Medicine, the authors call for action to tackle poor oral health among athletes. They say that simple measures such as encouraging better brushing and flossing could provide the same marginal performance gains as expensive physical therapies. The statement came out of the April 2014 Oral Health and Performance in Sport collaboration ...

High carb diet, acidic sports drinks and eating disorders take toll on athletes' teeth

2014-10-14
But diet is not the only culprit, says the Statement. There is little in the way of education or encouragement to help athletes appreciate the importance of good dental health on their training and performance, it says. The Consensus Statement, which draws on a comprehensive review of the published evidence and a recent symposium on the lessons of the London 2012 Olympic Games, is intended as a call to action. The UK and North American authors, all experts in dental health and sport and exercise medicine, point out that dental consultations accounted for almost a third ...

Nearly 1 in 3 UK lung cancer patients dies within 3 months of diagnosis

2014-10-14
The findings suggest that family doctors may not be picking up the signs of lung cancer and investigating them as appropriately as they might, or promptly enough, say the researchers. The UK lags behind other countries in survival rates for lung cancer, a gap that has largely been attributed to late diagnosis of the disease. In a bid to find out more about the factors in primary care associated with these figures, the researchers analysed family doctors' (GPs') investigation of lung cancer between 2000 and 2013. They used data from The Health Improvement Network (THIN), ...

Some sections of the San Andreas Fault system in San Francisco Bay Area are locked, overdue

2014-10-14
SAN FRANCISCO – Four urban sections of the San Andreas Fault system in Northern California have stored enough energy to produce major earthquakes, according to a new study that measures fault creep. Three fault sections – Hayward, Rodgers Creek and Green Valley – are nearing or past their average recurrence interval, according to the study published in the Bulletin of the Seismological Society of America (BSSA). The earthquake cycle reflects the accumulation of strain on a fault, its release as slip, and its re-accumulation and re-release. Fault creep ...

Tip sheet from Annals of Internal Medicine Oct. 14, 2014

2014-10-14
1. Experts urge cautious use of experimental Ebola drugs While a World Health Organization (WHO) advisory panel says it is ethical to use experimental medications and vaccines on Ebola patients, experts caution that these drugs are not without risks, and physicians must carefully triage patients or risk serious adverse events, according to a commentary being published in Annals of Internal Medicine. The WHO's epidemic-specific conclusion mandates that health care professionals employ particular ethical standards (fairness of dissemination, patient consent, physician nonmaleficence) ...

Study reports on medical resident knowledge of High Value Care via exam vignette

2014-10-14
Philadelphia, October 14, 2014 -- High Value Care sub-scores from the Internal Medicine In-Training Examination (IM-ITE) reflect the importance of training medical residents to understand the benefits, harms, and costs of tests and treatments, according to a study published today in Annals of Internal Medicine. The IM-ITE is a multiple-choice exam developed by the American College of Physicians (ACP) in collaboration with the Alliance for Academic Internal Medicine (AAIM) to help residents along with their program directors assess their knowledge of internal medicine ...

Living near major roads may increase risk of sudden cardiac death in women

2014-10-13
Living close to a major road may increase women's risk of dying from sudden cardiac death, according to new research in the American Heart Association journal Circulation. "It's important for healthcare providers to recognize that environmental exposures may be under-appreciated risk factors for diseases such as sudden cardiac death and fatal coronary heart disease," said Jaime E. Hart, Sc.D., study lead author and an instructor in medicine at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts. "On a population level, living near a major roadway ...

Guideline offers direction in genetic testing for certain types of muscular dystrophy

2014-10-13
MINNEAPOLIS – A new guideline from the American Academy of Neurology (AAN) and the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) recommends guidance on how doctors should evaluate the full picture—from symptoms, family history and ethnicity to a physical exam and certain lab test results—in order to determine what genetic tests may best diagnose a person's subtype of limb-girdle or distal muscular dystrophy. The guideline is published in the October 14, 2014, print issue of Neurology®, the medical journal of the American ...

Study estimates 14 million smoking-attributable major medical conditions in US

2014-10-13
Bottom Line: Adults in the United States suffered from approximately 14 million major medical conditions attributable to smoking. Author: Brian L. Rostron, Ph.D., M.P.H., of the Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Md., and colleagues. Background: Smoking is the leading cause of preventable disease in the United States. Cigarette smoking harms nearly every organ and organ system in the body. The authors estimated major medical conditions (morbidity) attributed to smoking in 2009. How the Study Was Conducted: The authors ...

No association seen between physical activity, depressive symptoms in adolescents

2014-10-13
Bottom Line: A study of teenagers suggests there is no association between physical activity (PA) and the development of depressive symptoms later in adolescence. Author: Umar Toseeb, Ph.D., of the University of Cambridge, United Kingdom, and colleagues. Background: Depression contributes to the global burden of disease. A reduction in the associated costs – both personal and financial – would benefit society. The onset of depression is thought to happen in adolescence or earlier so preventive measures during this period of life could be beneficial. PA ...

LAST 30 PRESS RELEASES:

Pink skies

Monkeys are world’s best yodellers - new research

Key differences between visual- and memory-led Alzheimer’s discovered

% weight loss targets in obesity management – is this the wrong objective?

An app can change how you see yourself at work

NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals

New research shows that propaganda is on the rise in China

Even the richest Americans face shorter lifespans than their European counterparts, study finds

Novel genes linked to rare childhood diarrhea

New computer model reveals how Bronze Age Scandinavians could have crossed the sea

Novel point-of-care technology delivers accurate HIV results in minutes

Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others

Study finds nearly five-fold increase in hospitalizations for common cause of stroke

Study reveals how alcohol abuse damages cognition

Medicinal cannabis is linked to long-term benefits in health-related quality of life

Microplastics detected in cat placentas and fetuses during early pregnancy

Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming

Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly

Alcohol makes male flies sexy

TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income

Study links teen girls’ screen time to sleep disruptions and depression

Scientists unveil starfish-inspired wearable tech for heart monitoring

Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs

AI effectively predicts dementia risk in American Indian/Alaska Native elders

First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes

Existing international law can help secure peace and security in outer space, study shows

Pinning down the process of West Nile virus transmission

UTA-backed research tackles health challenges across ages

In pancreatic cancer, a race against time

Targeting FGFR2 may prevent or delay some KRAS-mutated pancreatic cancers

[Press-News.org] Stenting safe and effective for long-term stroke prevention
Using stents to keep neck arteries open is just as effective as invasive neck surgery for long-term prevention of fatal and disabling strokes