Harvard Men's Health Watch

Stents or surgery for clogged neck arteries?

Two common approaches to treating narrowed neck arteries—surgery and angioplasty plus stent placement—prevented disabling strokes equally well, according to results of an international clinical trial published in The Lancet. The 1,700 participants at 50 different medical centers worldwide had a condition called carotid stenosis, in which one or both of the main arteries in the neck that supply blood to the brain become clogged with fatty deposits.

Clotting or complete blockage can trigger a stroke. In fact, about 15% of all strokes are associated with carotid clogging. For this reason, people already experiencing symptoms from a blockage may be offered either surgery to clear the blockage or a procedure to install a stent—a small metal cage-like tube that holds the blocked area open.

The participants were split into two groups and treated with either surgery or stenting. Doctors checked in on them periodically to see if they'd had any strokes. At five years, the rate of fatal or disabling stroke was 6.4% in the surgery group and 6.5% in the stent group—not a meaningful difference.

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