शुक्रवार, 21 सितंबर 2012

Are Stroke Drugs Better Than Stents?

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


carotidarterynih



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