Specialists boost hope of stroke prevention

A report by experts in Sheffield has found that widening the major artery leading to the brain using a metal tube known as a stent is just as effective as the most common alternative treatment using open surgery.

It found it also has the additional benefits of taking less time, involves less interventional surgery and leads to faster discharge from hospital.

The work examining stents, which can be inserted through a small hole in the skin without the need to open up the neck, was based on more than 1,100 cases from 31 centres, including half from Sheffield, of patients suffering from disease of their carotid artery, which leaves them vulnerable to strokes.

Co-author Stephen Goode, a specialist registrar in interventional radiology in Sheffield, said: “This work is significant as it provides firm evidence on which clinicians in the UK can base their decisions in trying to prevent stroke.

“Stenting offers similar safety levels in the short term to open surgery and also has a similar effect on stroke prevention, with the benefits of a less invasive procedure and a quicker recovery.

“Patients who are not able to have open surgery can often be treated with stents, whilst others would prefer the procedure as it is less invasive. However, not all patients are suitable for stenting and often open surgery and stenting are complementary, allowing more patients to receive effective stroke prevention.”

Nearly three quarters of patients were discharged within a day of treatment which is quicker than full surgery. Four in five patients were still alive after seven years which compared well with patients who had undergone open surgery.

The report also found that, unlike in open surgery, women did just as well as men straight after the procedure and had even better outcomes in the long term. For both men and women, it found that the long-term risk of stroke was low.

Early findings of the study by experts at Sheffield Teaching Hospitals NHS Foundation Trust and Sheffield University were so significant that they were included in national guidance on carotid disease published this year.

Dr Goode said: “Our challenge now is to move forward with this work and help to embed carotid stenting in clinical practice in an appropriate way around the UK.

“The number of stenting procedures carried out in this country is relatively low despite the fact that the procedure can contribute significantly to providing patients with effective interventions in a timely manner. We hope that this report and our future work in this area will help to change this.”

A person’s genes can increase the risk of catching a type of bone marrow cancer by 30 per cent, a study suggests. The findings by a team led by the Institute of Cancer Research (ICR) could lead to improvements in diagnosis and treatment of multiple myeloma.

The aggressive cancer develops in plasma cells, which make antibodies that attack and kill viruses and infections.

Around 4,000 people are diagnosed each year with multiple myeloma and the average patient survives three to five years.

Relatives of multiple myeloma patients were known to have up to a four-fold increased risk of suffering the disease. This could be down to environmental factors as well as genetics but until now scientists have not been able to identify any genes responsible.