This article originally appeared in Connections, a magazine published for physicians and the community by UMass Memorial Medical Center.
According to findings of the 10-year, federally funded CREST (Carotid Revascularization Endarterectomy versus Stenting Trial) announced in February, stents to prop open plaque-clogged carotid arteries help reduce the risk of stroke as safely and effectively as traditional surgery (carotid endarterectomy) in appropriately selected patients - and they do so less invasively and with shorter hospitalizations.
Ajay Wakhloo, MD, PhD, is encouraged by these findings. Director of neurointerventional radiology/endovascular neurosurgery at UMass Memorial Medical Center, he has performed more than 2,000 carotid stent placements since he started doing the procedure in 1991, many under the umbrella of earlier clinical trials.
"This latest study shows that endovascular treatment is a viable option to surgery in a wider patient population," Dr. Wakhloo said. Currently, Medicare restricts reimbursement for carotid stenting to patients with previous stroke symptoms and who are high-risk surgical candidates. "But the technology has matured along with our experience," he continued. "And the outcome-benefit level is equal to that of surgery even in patients without stroke symptoms, and that's quite impressive." Mr. Wakhloo stressed that patient selection remains a key factor in achieving successful outcomes. "We have a unique opportunity to offer both services to patients here at UMass Memorial, and to help them make the best treatment decision," he said. "The age of the patient, co-morbidities - all go into the equation, and it's never black and white. We evaluate, understand the risks and tailor treatment to the individual needs of each person." Information: 508-856-6316