New stroke-prevention surgery

British study finds surgery to clean out deposits that narrow the main artery to the brain can halve the risk of stroke for people who have no telltale symptoms of impending trouble.

Only 6 percent of people with significant blockage but no symptoms who had the procedure, called carotid endarterectomy, suffered strokes over the next five years, compared to 12 percent of those with the same condition who did not have surgery, said a report in the May 8 issue of The Lancet.

"We think the balance of risk is strongly in favor of surgery," said Dr. Alison Halliday, a consultant vascular surgeon at St. George's Medical School in London, who led the Asymptomatic Carotid Surgery Trial.

The new results settle a controversy that arose from a similar but smaller American trial done from 1987 to 1993, said Dr. James Toole, a professor of neurology at Wake Forest Baptist Medical Center who led that trial.

Both trials produced essentially similar results, but the British study had nearly twice the number of participants, 3,120 compared to 1,662, reports forbes.com

According to BBC a major trial involving 3,000 patients from 30 countries has found that an operation to stop the arteries from narrowing can halve the risk of stroke. Some doctors have been reluctant to carry out the procedure because of the risks involved.

Patients with substantial narrowing of one of the main arteries, the carotid artery, are known to be at increased risk of stroke.

Half of those involved in this trial were given surgery to widen their carotid artery. The others did not.

The trial, which was funded by the UK's Medical Research Council and the Stroke Association, found that people who had the operation had a 3% risk of dying as a result of the surgery.

Over the course of five years, they had a further 3% chance of dying from stroke bringing their total risk to 6%.

However, people who did not have the operation had a 12% chance of dying from stroke over the five years.

Around 6000 men in England and Wales die from a ruptured abdominal aortic aneurysm every year, but evidence suggests many of these deaths are preventable.

A 13-year aneurysm screening programme running in Gloucestershire has seen a fall in deaths at a cost of £43,000 a year.

Doctors taking part in that programme today argued that a national programme across the UK could save thousands of lives if it was introduced, inform scotsman.com