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Stroke: medical intervention superior to surgery

A Baker IDI Heart and Diabetes Research Institute project reports finding that medical intervention alone is now superior to surgery in preventing stroke associated with sever vascular disease narrowing of the internal carotid artery in patients without previous related stroke symptoms.

04 Jul 2010

A Baker IDI Heart and Diabetes Research Institute project reports finding that medical intervention alone is now superior to surgery in preventing stroke associated with severe vascular disease narrowing of the internal carotid artery in patients without previous related stroke symptoms.

The findings come from a systematic review and analysis of stroke risk in patients with asymptomatic severe carotid narrowing conducted by Senior Research Fellow Dr Anne Abbott. Her report is published in Stroke: Journal of the American Heart Association.

Her findings suggest that current vascular disease medical intervention alone is at least 3-8 times cheaper in preventing stroke than surgery and that it prevents other symptoms of vascular disease such as heart attack and complications from poor leg circulation.

Dr Abbott found no evidence “that carotid angioplasty or stenting for asymptomatic patients improves the stroke prevention efficacy of current medical intervention alone”.

The implications for best practice treatment were significant, she said.

The fall in stroke symptom rates for patients with asymptomatic severe carotid narrowing coincided with “great gains” in understanding of risk factors and non-invasive treatment for vascular disease such as the importance of healthy lifestyle habits and the appropriate use of effective medications to retard platelet action and control high blood pressure, high blood cholesterol and diabetes.

“Contrary to common practice, the most appropriate referral path for patients identified with asymptomatic carotid narrowing is now to an enthusiastic clinician with expertise in current medical vascular disease, and not to a surgeon.”


Published: 04 Jul 2010