Innovative Scoring System Aims to Reduce Unnecessary Carotid Artery Surgeries

A recent breakthrough in cardiovascular care introduces the Carotid Artery Risk (CAR) score, a new predictive tool designed to help doctors determine the most appropriate treatment for patients with clogged arteries. Traditionally, individuals with carotid artery blockages often undergo surgical procedures such as carotid endarterectomy or stenting to restore blood flow, but these interventions carry significant risks, including the possibility of stroke or other complications.

The CAR score enables clinicians to assess a patient’s specific risk of stroke over the next five years based on a combination of factors, guiding them toward personalized treatment plans. Patients identified as low or intermediate risk may benefit more from a conservative approach involving medications—such as cholesterol-lowering drugs, blood pressure management, blood thinners—and lifestyle modifications, rather than immediate surgical intervention.

In a clinical trial involving 428 adults from various hospitals across the UK, Europe, and Canada, those who received tailored medical therapy based on their CAR score experienced very low rates of strokes and heart attacks over two years. Interestingly, patients who underwent surgery did not demonstrate significant benefits compared to those managed with medication and lifestyle changes.

Senior researcher Dr. Martin Brown from University College London emphasizes that using the CAR score could help avoid unnecessary surgeries, reducing patient discomfort and medical risks, while also saving healthcare costs. This approach advocates for detailed individual risk assessments and intensive management of vascular risk factors.

The trial focused on patients showing symptoms related to artery narrowing, with participants being randomly assigned to receive either medication alone or combined with surgical procedures when deemed necessary. The treatments included dietary changes, cholesterol-lowering medications, blood pressure regulators, and blood thinners. The ongoing study aims to further validate these findings.

Experts like Dr. Louise Flanagan from the Stroke Association highlight that the CAR score offers a promising alternative to invasive surgery, potentially leading to safer, more effective management of carotid artery disease. While additional research is needed, this development marks a significant step toward personalized, less invasive stroke prevention strategies.

Source: https://medicalxpress.com/news/2025-04-scoring-unnecessary-surgery-clogged-arteries.html