Press Release

EMBARGOED FOR RELEASE:
Contact: Tom Capezzuto
JUNE 4, 2003, 4 p.m.
(973) 972-7273
E-mail:capezzta@umdnj.edu

At UMDNJ-New Jersey Medical School
UMDNJ Vascular Surgeon Achieves Low Mortality Rate in Carotid Artery Stenting

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 said.

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of the five-year nationwide study, known as Carotid Revascularization Endarterectomy versus Stent Trial (CREST), will not be published until later next year.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 intervention.

"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.

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