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1 in 10 Still Have Stroke Surgery Unnecessarily

The May 8, 2003 issue of the journal Stroke: Journal of the American Heart Association reports that 1 in 10 people are having a common stroke surgery even though they are not good candidates and the risks outweigh the benefits.

The surgery is called carotid endarterectomy. It involves stripping fatty plaque from neck arteries that are dangerously clogged in order to decrease the risk of stroke. However, the procedure itself can increase the risk of stroke if small pieces of plaque break loose and travel to the brain.

In the study, researchers examined the files of 2,124 patients who underwent the surgery at six New York hospitals between 1997 and 1999.

In nearly 11% of the cases, endarterectomies were performed inappropriately. This would amount to about 14,000 unnecessary surgeries a year.

When the researchers looked closer at the inappropriate surgery group they found that 27% of them didn’t have enough blockage to justify the procedure. They also found that nearly half of the people in the inappropriate surgery group were too sick with other illnesses to have had the procedure in the first place. Many of the patients had heart failure, high blood pressure, diabetes, heart or kidney disease that should have precluded the surgery had they been good candidates.

The authors conclude that patients facing the surgery should ask their doctor if they are too sick to have the procedure and to get a second opinion.

Commentary: We suggest a third or fourth opinion.

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