Results of study show new options for patients at-risk for stroke

Knoxville, Tenn. --- For almost 10 years, Malcolm Foster, M.D., cardiologist with East Tennessee Heart Consultants and Director of Cardiovascular Research for Mercy West, was the East Tennessee Principle Investigator for a groundbreaking research project in hopes of finding a better way to treat patients who have blockages in their carotid arteries. Today, the results for the study, known as CREST (for Carotid Revascularization Endarterectomy vs. Stenting Trial) were released at a medical meeting in San Antonio. Dr. Foster said that he first wants to acknowledge the patients and his gratitude for their willingness to participate in the study and the physicians, nurses and staff who support them. “This was a big commitment from the patients,” said Dr. Foster. “These were people who were at risk for a stroke, but they were willing to be part of the clinical trial in order to help others like them in the future.” CREST was a randomized trial where 50% of the patients received a stent and 50% received surgery. Until now, surgery was thought to be the most effective procedure for dealing with a blocked carotid artery, which runs up both the side of the neck and supplies blood to the brain. However, the results of CREST show similar long-term outcomes between surgery and stenting. In the short term, there were some differences with more TIA and strokes with stents, and more heart attacks and nerve damage with surgery, but the long-term outcomes were very similar. Carotid artery stenting is less invasive than surgery and is performed using a catheter, like one used in a heart catheterization, to place a mesh-like stent the narrowed part of an artery. The stent is then opened and blood flow is restored to the brain. Carotid stenting is currently restricted to high-risk patients, but Dr. Foster said the results from CREST will allow new options for most patients with a blocked carotid artery. “This is good news for patients because it gives patients more options. We now have two very good treatments with similar outcomes and we can make decisions that are in the best interest of the patient and their care.” Dr. Foster is a board-certified interventional cardiologist with a special interest in peripheral vascular disease and cardiovascular research. He is a partner at East Tennessee Heart Consultants and Director of Cardiovascular Research at Mercy West. He is also a course instructor for carotid artery stenting and advanced endovascular techniques, and physicians from across the country and around the globe come to Knoxville to train with him. Dr. Foster has lived in Knoxville since 2001 and his office is located in the Physicians Plaza at Mercy West (phone: 865-470-2273).