Are Stroke Drugs Better Than Stents?
(STROKE:STOPPAGE OF BLOOD FLOW TO BRAIN IS A SUDDEN BLOCKAGE OR RUPTURE OF A BLOOD VESSEL IN THE BRAIN RESULTING IN ,e.g. loss of
consciousness,partial loss of movement ,or loss of speech .Technical name cerebrovascular accident (brain attack ).
Medical -Device Makers Lobby Medicare to Widen Coverage but Some Doctors Oppose More Surgeries
Unclogging Arteries
Patients with artery blockage in the neck have two aggressive treatment options :carotid surgery or stents.But some doctors argue drug therapies have surpassed both.
CAROTID SURGERY
A surgeon makes a cut in the neck to reach the narrowed or blocked carotid artery ,removing the plaque.
Carotid artery is a large artery on either side of the neck that supplies blood to the head .
U.S.CAROTID SURGERIES PERFORMED ANNUALLY 109 ,000
DEATH AND STROKE RATE Within 30 days
2.6%
DRUG THERAPIES
Millions of Americans take drugs for stroke prevention , at fraction of the cost of surgery ,though no major studies exist of patients randomly assigned to drugs ,surgery or stents .
Monthly retail price for some drugs : Clopidogrel (Plavix) ,75 mg/day $175
Atorvastatin (Lipitor), 80 mg/day $150
Hydrochlorothiazide (various brands ), 25 mg/day $12
THE CONDITION
The buildup of plaque or blood clots can severely narrow or block the carotid arteries ,This limits the flow of oxygen -rich blood to your brain and can cause a stroke.
Plaque is a deposit on the inner wall of an artery (coronary artery or carotid artery).coronary artery supplies blood to the heart ,carotid to the head.
ANGIOPLASTY AND STENTING
A thin tube with a balloon is threaded through the blocked carotid artery .The balloon is inflated to push the plaque against the wall of the artery .A stent is then inserted to hold the plaque and keep the artery open .
U.S. CAROTID STENTS ANNUALLY 16,000
A CAROTID OPERATION IN U.S . $21,200
A CAROTID STENT PLACEMENT $33,500
This is eight times what drug treatment would cost .
Approximate number of Americans who get carotid surgery or carotid stents yearly 125,000 .
Source :THE WALL STREET JOURNAL /Wednesday ,September 19 ,2012/ PAGES,B1,B2
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