Surgery for narrow arteries
I've used this one before but it's worth repeating because it applies to so many situations: two American surgeons talking, and one says, "So what did the patient have?" and the 2nd one says, "a thousand dollars."
"No," the first surgeon persists, "I mean why did you operate?"
"I told you," is the immediate reply. "A thousand dollars."
And a cynic might say that that is also the main explanation behind the recent finding that one of the more common operations done on neurosurgical patients, opening up what is deemed to be a narrowed carotid artery in the neck to lower the eventual risk of stroke (most often from a blood clot that forms in the narrowed artery), is actually unwarranted in 95 % of occasions.
Yup, according to this Canadian study, and that's important because Canadian surgeons are generally less intervention-oriented than American surgeons are, 95 % of asymptomatic patients who have surgery on a narrowed carotid artery or who have a carotid artery stent ( as strut to keep the artery open) do as well long-term plain old medical therapy as they do with surgery.
And those who elect medical therapy do not run, of course, the huge risks that accompany surgery on a sick vessel going to the brain.
There is no one-size-fits-all answer to this common problem but this study certainly indicates that if you are told that you - or someone you love - need such surgery, you'd best ask a lot of hard questions about your options.
Written by Webmaster
Tuesday, 28 October 2008 04:25
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