EMBARGOED FOR RELEASE:
Contact: Tom Capezzuto
JUNE 4, 2003, 4 p.m.
At UMDNJ-New Jersey Medical School
UMDNJ Vascular Surgeon Achieves Low Mortality Rate in Carotid
Study of 105 'High-Risk' Patients Published in June 2003 Journal
of Vascular Surgery
A new study by a vascular surgeon at the University of Medicine
and Dentistry of New Jersey (UMDNJ) indicates that carotid artery
stenting may be the safest procedure for preventing strokes in
elderly patients at high risk for these episodes.
The results of this study showed that less than three percent
of those who had the stenting procedure suffered a stroke or died
within 30 days of the minimally invasive procedure, the lowest
mortality rates recorded in similar studies nationwide, said Dr.
Robert W. Hobson II, director of the Division of Vascular Disease
at the UMDNJ-New Jersey Medical School in Newark, who led the
study and performed the stenting procedure, which he helped pioneer
more than five years ago.
The study is published in the June 2003 issue of the Journal
of Vascular Surgery.
"This procedure, which is less invasive than a carotid endertarectomy--the
other approach to treating accumulated arterial plaque--appears
to greatly reduce the risk or recurrence of a stroke or heart
attack in individuals who are at the greatest risk," Dr. Hobson
This study is part of a larger nationwide study for which Dr.
Hobson received a record $22.3 million grant from the National
Institute of Neurological Disorders and Stroke. The results of
the five-year nationwide study, known as Carotid Revascularization
Endarterectomy versus Stent Trial (CREST), will not be published
until later next year.
Carotid artery stenting involves passing a fine catheter with
a balloon end into the carotid artery through the groin. The catheter
dilates the artery and clears the plaque that is clogging it.
A stent, which is a very fine titanium/steel mesh piece, is then
inserted through the catheter into the artery to keep it open
to maintain blood flow.
"Without the insertion of a stent, patients have a greater chance
of the artery closing within six months and potentially contributing
to a recurring blockage, known as restenosis, and increased risk
of stroke," Dr. Hobson said.
Carotid endarterectomy involves surgically scraping the lining
of the carotid artery to remove an accumulation of fatty deposits
and plaque in order to restore normal blood flow to the brain.
In this study, Dr. Hobson performed the stenting procedure on
105 patients whose average age was 70; 63 (60 percent) were men
and 42 (40 percent) were women. In 74 patients (65 percent), a
carotid endarterectomy had been performed previously, but plaque
subsequently reappeared in the arteries, resulting in secondary
"As a result of the stenting procedure, the mortality rate of
these patients was only 2.85 percent," Dr. Hobson said. "Although
the data from the CREST trial is inconclusive at this time, this
study involving carotid stenting shows that the stroke and mortality
rates are significantly lower than other recently published clinical
trials in the United States that showed a 10 to 12 percent death
rate or stroke recurrence among treated patients."
The UMDNJ-New Jersey Medical School is one of three medical
schools of the University of Medicine and Dentistry of New Jersey.
UMDNJ comprises New Jersey's only three medical schools, the state's
only dental school, a nursing school, a graduate school biomedical
sciences, a school of health related professions and a school
of public health on campuses in Newark, Piscataway/New Brunswick,
Camden, Stratford and Scotch Plains. UMDNJ also operates University
Hospital, Newark, and University Behavioral HealthCare. It is
affiliated with more than 200 health care and educational institutions
throughout the state.