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【medical-news】研究发现颈支架增加中风风险
Study: Neck Stents Present Stroke Risk
By MIKE STOBBE
The Associated Press
Wednesday, October 18, 2006; 5:24 PM
-- An experimental treatment used to clear clogged neck arteries carries a higher-than-expected risk of stroke and death, according to a study that was stopped early for safety reasons.
The study compared the use of stents _ small tubes that prop open blood vessels _ with a common surgical procedure for cleaning out blockages in the carotid artery. Deaths and strokes were more than twice as common in patients treated with stents, the researchers found.
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The findings conflict with influential earlier research, which found stents to be safer.
"The jury is still out," said Dr. Anthony Furlan, a vascular neurologist at the Cleveland Clinic.
Furlan wrote an editorial that accompanies the new study, published in Thursday's New England Journal of Medicine.
At issue is the best way to treat patients who develop blockages in the carotid, a key artery that supplies blood to the brain. The blockages are caused by plaque, a cheesy buildup of fat and cholesterol.
Many people with partial blockages do not experience symptoms. But the condition can cause a mini-stroke with temporary symptoms such as loss or blurring of vision in one eye, or weakness or numbness in an arm or leg. If left untreated, a blockage can lead to a major stroke or death.
In the standard treatment, doctors clamp off the artery and clean it out surgically. But that can be risky, especially for patients with heart damage or problems in the other carotid artery.
Doctors developed another treatment, in which they use a catheter to string a wire mesh stent into the artery that expands and props the artery open.
U.S. doctors have been doing carotid stenting since the mid-1990s. But the Food and Drug Administration has approved stenting only in patients who have symptoms from an artery that is blocked 70 percent or more and for whom surgery would be highly risky.
In the new study, French researchers recruited adult patients who had symptoms, a 60 percent or more blockage of the carotid artery, and an average surgery risk. Of the 520 participants, half got surgery and half got stents.
A month after undergoing the procedures, nearly 10 percent of the stented patients suffered death or stroke, versus only 4 percent of the surgical patients.
Here are the numbers: In the stent group, two people died and 23 others suffered a stroke. In the surgical group, three died and seven more suffered stroke.
In contrast, a 2004 U.S. study of patients with high surgery risk found the incidence of death, stroke or heart attack was about 5.5 percent in patients treated with a stent and 10 percent in patients treated with surgery. The difference was attributed to fewer heart attacks in the stent patients. Study: Neck Stents Present Stroke Risk
By MIKE STOBBE
The Associated Press
Wednesday, October 18, 2006; 5:24 PM
-- An experimental treatment used to clear clogged neck arteries carries a higher-than-expected risk of stroke and death, according to a study that was stopped early for safety reasons.
因为安全因素已经中止的一项研究显示，对狭窄的颈动脉进行的支架治疗所带来的中风和死亡危险性超过预期。
The study compared the use of stents _ small tubes that prop open blood vessels _ with a common surgical procedure for cleaning out blockages in the carotid artery. Deaths and strokes were more than twice as common in patients treated with stents, the researchers found.
本研究比较了支架和颈动脉环切术——通过小管打开血管，采用常规手术步骤清楚颈部动脉中的阻塞。发现放置支架的病人的中风和死亡危险性较支架增加2倍多。
The findings conflict with influential earlier research, which found stents to be safer.
以前的研究结果认为放置支架更加安全，本研究与以上结论不同。
"The jury is still out," said Dr. Anthony Furlan, a vascular neurologist at the Cleveland Clinic.
Cleveland医疗中心神经血管科大夫指出：“争论还在继续”。
Furlan wrote an editorial that accompanies the new study, published in Thursday's New England Journal of Medicine.
Furlan写了一篇相关的述评，在本周二与本研究结果一起发表在《新英格兰医药》杂志上。
At issue is the best way to treat patients who develop blockages in the carotid, a key artery that supplies blood to the brain. The blockages are caused by plaque, a cheesy buildup of fat and cholesterol.
颈动脉是脑部供血的关键血管，阻塞是由于斑块（脂肪或者胆固醇结晶的积聚）造成的，颈动脉阻塞的最佳治疗手段还是手术切开处理。
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作者:admin@医学,生命科学 2010-12-09 05:11
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