Meaningful Treatments

Thankfully, we’ve learned from our mistakes. Opening blocked vessels is useful in really only two general areas:

Heart attack, where the rule of thumb is to open the tightest blockage (we refer to it as the “infarct-related artery”) and leave the rest as is.

Symptomatic blockages such as the 99% plug that caused my patient his troubles. If, on the other hand, a person has no chest pain or breathing difficulty associated with the disease, we provide no benefit by uncorking it—even if the blockage is 100%.

via Meaningful treatments in the battle against coronary disease.

Carotid Artery Stenosis – Endarterectomy or Stent?

Short term and intermediate term comparison of endarterectomy versus stenting for carotid artery stenosis: systematic review and meta-analysis of randomised controlled clinical trials — Meier et al. 340: c467 — BMJ

Conclusions Carotid endarterectomy was found to be superior to carotid artery stenting for short term outcomes but the difference was not significant for intermediate term outcomes; this difference was mainly driven by non-disabling stroke. Significantly fewer cranial nerve injuries and myocardial infarctions occurred with carotid artery stenting.