I too was curious as to what kind of surgeon was performing the CEA's.
Neuro? Vascular? General/Vascular? And how do they decide when to stent?
How much stenosis must exist before stent? 80%, 70%, 60%? Symptomatic pts,
Asymptomatic pts, both? Of the 723 pts, how many had stent? how many had
CEA? I even thought the 5.8% stent risk was a little high. Would be
difficult to tell a pt that they had a 1 in 20 chance of developing MI, CVA,
or death during stent placement. Of course that would sound a little
attractive to their over 1 in 10 chance with CEA (12.6%)....YIKES.
Jeff Stanley BS,RVT
The Heart Group
Nashville, TN
-----Original Message-----
From: Johnson, Bonnie L. [mailto:[log in to unmask]]
Sent: Monday, November 25, 2002 11:26 AM
To: [log in to unmask]
Subject: Re: Stent versus endarterectomy
I am with you on this Terry. Those numbers are outrageous. Do you happen to
know what kind of surgeon or setting those surgeries were performed in? bj
Bonnie L. Johnson RDMS, RVT, FSVT
Stanford University Medical Center
Director, Vascular Laboratory Services
Division of Vascular Surgery
Stanford, CA
-----Original Message-----
From: T.D.Case [mailto:[log in to unmask]]
Sent: Monday, November 25, 2002 4:51 AM
To: [log in to unmask]
Subject: Stent versus endarterectomy
Colleagues;
A recent study performed at the Cleveland Clinic and released at the
American Heart Association meeting in Chicago, reviewed 723 patients and
compared two groups (endarterectomy and stent placement) for perioperative
risks which include CVA, MI or death within 30 days of the procedure. The
study reports that stents had 5.8% risk compared to that of endarterectomy,
which had 12.6% risk therefor concluding the superiority of stent placement.
While the numbers appear impressive, isn't a 12.6% surgical perioperative
risk unusually high? It was my understanding that medical centers having
proficency in vascular surgery had risk closer to the 2% to 3% area.
Terry Case
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