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(Ivanhoe Newswire) -- Many people who are at risk for stroke may be able to take medication to prevent one instead of having surgery.
New research from the University of Western Ontario shows more intensive medical therapy has lowered the risk of stroke so much that at least 95 percent of patients with asymptomatic carotid stenosis (ACS) would be better off with medical therapy than with surgery or stenting. ACS is a narrowing in the carotid artery -- which supplies blood to the brain -- and has not yet caused a stroke or transient ischemic attack (TIA).
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Researchers say the less than five-percent of ACS patients who could benefit from revascularization can be identified with Transcranial Doppler Embolus Detection -- a procedure where arteries inside the head are monitored for microemboli -- small blood clots or chunks of plaque that break off from the narrowing in the carotid artery and go into the brain arteries.
The study looked at 471 ACS patients. Of the patients, 199 were seen before 2003; 272 were seen after January 1, 2003. Results show microemboli in 12.6 percent of patients before 2003, but in only 3.7 percent since 2003. The decline was associated with better control of plasma lipids and slower progression of carotid plaque. There have been significantly fewer strokes and heart attacks since 2003.
The 96- percent of patients without microemboli have only a one percent risk of stroke in the next year, whereas the ones with microemboli have a 14 percent risk of stroke, lead researcher, Dr. David Spence, of the University of Western Ontario, was quoted as saying. Since the risk of surgery is four to five percent, patients without microemboli are better off with medical therapy including medications and lifestyle modifications. Only the ones with microemboli would benefit from carotid endarterectomy or stenting.
SOURCE: 6th World Stroke Congress in Vienna, Austria, September 24-27, 2008
The article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
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