Stent Safe in Symptomless Heart Disease

Patients with heart disease but no symptoms may be better off with a carotid stent than standard surgery.

Researchers are hoping this new data will convince the Centers for Medicare & Medicaid Services to cover the stenting procedure for asymptomatic patients, which the agency does not currently do.

Findings from the CAPTURE study — the largest-ever multi-center U.S. registry on the efficacy of carotid stenting — showed that asymptomatic heart-disease patients had a lower rate — or 5.7 percent — of major complications, including stroke, heart attack or death, within 30 days of the stenting procedure, compared with patients in other studies who had undergone surgery.

The study noted that patients with carotid-artery blockage but no symptoms are at high risk for stroke and in fact have a one in eight chance of having a stroke in five years if they use only drugs.

But since Medicare doesn’t cover carotid stenting in asymptomatic patients, some with the disease turn to standard surgery, while others can’t risk surgery’s complications due to other medical conditions.

The scope of this landmark trial provides us with a clear picture of the patients who benefit the most from carotid artery stenting. We hope these results will expand coverage to asymptomatic patients who are risky candidates for surgery, said William Gray, lead investigator on the study and associate professor of clinical medicine at Columbia University Medical Center.

The researchers looked at data on 2,500 patients at increased risk for surgery who received Guidant’s Acculink carotid stent. The research was unveiled Tuesday at the American College of Cardiology meeting in Atlanta.