Death Toll High in Artery Surgery, Study Finds

A new study suggests that an increasingly popular operation designed to prevent strokes by removing clogged segments of arteries feeding the brain may be causing thousands of needless deaths.

Dr. Mark L. Dyken, chairman of the neurology department at Indiana University School of Medicine, said in a report released Wednesday that he found 2.8% of those who undergo the operation die before they are discharged from the hospital.

Another 5.6% to 17% die of complications later or suffer a fatal stroke anyway, he said.

Toll Estimated at 11.2%

“Roughly 11.2% of those who had the operation died, versus 2% of those who did not have the operation but were treated with drugs,” Dyken said at an American Heart Assn. seminar.

He said the number of such operations increased from 15,000 in 1971 to 103,000 in 1984. He estimated that between 3,800 and 11,650 unnecessary deaths occur annually in the United States because of the operation.

“It seems the cure is more dangerous than the disease itself,” he said. “But what we really show is that we need a more comprehensive study to determine the benefits of this surgery.”

Dyken said he believed the surgery may only be of value to people who have already suffered stroke symptoms--such as partial paralysis and headaches--stemming from fatty plaque in the arteries to the brain.

35,000 Held Candidates

Dyken said a colleague estimates that only 35,000 people are candidates for the surgery each year. His own estimates are one-tenth of that figure.

Called endarterectomy, the operation consists of removing fat-obstructed sections of the carotid arteries that supply blood to the brain. Physicians believe these diseased arteries are a source of blood clots that lead to strokes.

Dyken’s report follows a recent Canadian study that showed another common brain operation was fatal more often than beneficial.

In that operation, a blood vessel is surgically placed in the brain to bypass an area obstructed by a stroke. The vessel, in theory, would shunt blood around the clogged artery to the blood-starved portion of the brain.

However, the Canadian study showed that drugs administered to thin the blood and squeeze it around the clot worked better than the operation.