The latest results from the longest-running study yet confirm that surgery is better than artery-opening angioplasty in preventing strokes caused by blockage of the carotid artery, the largest vessel carrying blood to the brain.

"In contrast with endovascular treatment [angioplasty], surgical patients had about half the rate of strokes in long-term follow-up," said Professor Martin M. Brown, Department of Brain Repair & Rehabilitation, consultant at the National Hospital for Neurology & Neurosurgery, and a senior author of two reports in the October issue of the Lancet Neurology.

Brown is a leader of the CAVATAS study, which has followed 504 people with carotid artery stenosis (narrowing) who were randomly assigned to have either the surgical procedure called endarterectomy or angioplasty.

"This was the first trial ever started comparing endovascular treatment with surgery," Brown said. Some participants in the trial have been followed for as long as eight years.

The second study reported on 413 CAVATAS participants who had periodic ultrasound examinations of the treated carotid arteries over the following five years. The study found that the incidence of severe re-narrowing of the carotid artery was much higher in the angioplasty group. (text adapted from US News & World Report)

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references>> The Lancet Neurology, Early Online Publication, 29 August 2009doi:10.1016/S1474-4422(09)70227-3
Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial. Leo H Bonati, Jörg Ederle, Dominick JH McCabe et al

The Lancet Neurology, Early Online Publication, 29 August 2009doi:10.1016/S1474-4422(09)70228-5
Endovascular treatment with angioplasty or stenting versus endarterectomy in patients with carotid artery stenosis in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial. Jörg Ederle, Leo H Bonati, Joanna Dobson et al