• Posted April 24, 2025

Scoring System Can Avoid Unnecessary Surgery For Clogged Arteries

THURSDAY, April 24, 2025 (HeathDay News) -- Doctors might be able to use a new scoring system to avoid unnecessary surgery to prevent strokes, a new study shows.

Patients with clogged arteries often undergo surgery to reopen blood vessels choked by plaques, but those procedures carry risk of causing a stroke or other serious complications.

A new system called the Carotid Artery Risk (CAR) score can identify patients who would be better treated with a combination of medications and lifestyle changes tailored to their individual risk factors, researchers reported in the May issue of The Lancet Neurology.

Patients treated with meds and lifestyle changes based on their score had very low rates of strokes or heart attacks during the first two years of a clinical trial testing the CAR score, researchers said.

And if patients got surgery to reopen clogged arteries, they did not experience significant benefits from the procedures, results showed.

“While further follow-up and additional trials are needed to confirm these findings, we recommend using the CAR score to identify patients with carotid narrowing who can be managed with optimized medical therapy alone,” senior researcher Dr. Martin Brown said in a news release. He is an emeritus professor with the University College London Queen Square Institute of Neurology.

“This approach emphasizes personal assessment and intensive treatment of vascular risk factors, potentially sparing many patients from the discomfort and risks of carotid surgery or stenting,” Brown said.  “Additionally, this method could lead to substantial cost savings for health services.”

For the clinical trial, researchers used the CAR score to assess 428 people 18 and older who had developed symptoms related to clogged arteries. The patients came from 30 hospitals in the U.K., Europe and Canada.

Patients with a low or intermediate risk of stroke over the next five years were recruited into the trial, and randomly assigned to just drugs and lifestyle treatment or similar medical therapy that could also include surgery.

Medical treatment could include a low cholesterol diet, cholesterol-lowering drugs, blood pressure meds and blood thinners, researchers said.

“The CAR risk score offers the opportunity to take away the downsides of surgery and stenting by using medical therapy alone as well as combining medical therapy with surgery,” Dr. Louise Flanagan, head of research at the Stroke Association, said in a news release after reviewing the findings. She was not involved in the study.

The clinical trial is ongoing, researchers said.

More information

Johns Hopkins Medicine has more on atherosclerosis.

SOURCE: University College London, news release, April 16, 2025