Reuters Health, September 29, 2011

People about to undergo a controversial stenting procedure in the neck might want to check their doctor's credentials first, researchers say. According to a new study in the Journal of the American Medical Association, patients whose doctors do lots of the procedures are nearly half as likely to die over the next month as those in less-experienced hands. During the treatment, called carotid stenting, doctors clean out cholesterol buildups in the carotid artery in the neck that sometimes cause strokes. Then they insert a small metal mesh tube, the stent, to prop the vessel open. But if they're unfortunate, part of the cholesterol deposit might break off during the procedure and be released into the blood stream, producing the dreaded stroke the patient hoped to avoid. Based on Medicare records of nearly 25,000 procedures, the new study found a 30-day death rate of 1.4% in patients whose doctors placed at least 24 stents a year. By contrast, that death figure was as high as 2.5% when the doctors did six or fewer procedures annually.
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