Magazine article Science News

Carotid Surgery Stands Test of Time

Magazine article Science News

Carotid Surgery Stands Test of Time

Article excerpt

Thousands of people have avoided strokes by opting for preemptive surgery that removes a coating of hard plaque from the inside of a vital neck artery. A new study finds that this surgery has long-term benefits and seems to protect against stroke even if done years after a patient first shows signs of such a blockage.

Symptoms of a blockage in the Y-shape carotid artery, which supplies the head with blood, include transient episodes of tingling or numbness in arms or legs, slurred speech, and a blackout of vision in one eye. Researchers see these as warning signs of stroke because the artery can close off or plaque can rupture and form clots that lodge in the brain. Symptoms of carotid blockages often go away within minutes or hours but the stroke risk remains.

Surgeons began clearing away such blockages, a procedure called carotid endarterectomy, in 1954. But organized trials to gauge its effectiveness didn't begin until the 1970s. The surgery remains controversial because the operation carries a risk of causing the very kind of stroke it seeks to avert (SN: 4/11/98, p. 229).

In the September STROKE, researchers report on patients diagnosed between 1987 and 1991 with symptoms and with one branch of their carotid artery largely blocked. Some patients then received medication only, while others got medication and surgery.

The scientists watched for strokes originating on the side of the brain fed by the partially blocked artery. About 28 percent of patients getting medication but no surgery had such a stroke in the first 3 years of the study. …

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