Journal scan
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JOURNALSCAN |
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Please
visit the Heart website (www.heartjnl.com) for links to these
articles
many to full text.
IQBAL MALIK
Editor, JournalScan
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ISCHAEMIC HEART DISEASE |
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Bored with PTCA? What
about carotid stenting? The more adventurous interventionalist
is always on the lookout for a new procedure. The
Lancet offers what looks like equivalence at three years for carotid endarterectomy and angioplasty (with a 30%
stent rate). However, the combined major stroke/death rate was 10% in
both groups at 30 days, higher than 6.5% in the NASCET trial and 7.0%
in the ECST trial. In addition, there was no medically treated control
group. One could reason that the reason for equivalence (with wide
confidence intervals) was that surgery did not produce the benefits
expected. The rule has to be that the surgeon has to have a low rate of
stroke/death at 30 days to consider surgery a good option over medical
treatment, and that angioplasty at present should
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