For 40 years, doctors have cleared blockages of the carotid arteries in the neck, which supply blood to the head, by surgically removing plaque from the vessels. The technique contrasts with a common way for treating artery obstructions around the heart. Once known mainly as balloon angioplasty, the latter procedure involves snaking an inflatable catheter through a small incision to open the vessel from the inside and then inserting a mesh cylinder called a stent to keep the artery open. Today, doctors commonly call that combination of procedures "stenting."
In the past decade, some doctors have tested stenting on blocked carotids. A direct comparison of stenting and plaque-removing surgery, called endarterectomy, now finds that the two approaches benefit patients about equally, with a slight edge going to stents, scientists report in the Oct. 7 New England Journal of Medicine.
A carotid artery blocked by plaque is a tragedy waiting to happen. When these plaque