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Dr. Pile-Spellman in his office D E AT H R AT E R EL AT ED TO S T R O K E I S I N D EC LI N E IN LATE 2014, stroke dropped from the fourth leading cause of death in the United States to the fifth leading cause of death, according to statistics from the American Heart Association. This fall in rankings is a testament to the great strides being made in stroke response and treatment. The decline in stroke-related deaths is most drastically seen in those younger than age 65, which has greatly reduced the years of poten - tial life lost, according to the American Stroke Association. Control of hypertension is one of the major factors in reducing stroke risks. Although the number of stroke-related deaths is declining, the fight to further reduce mortality rates continues. An aging population and increasing numbers of younger individuals being diagnosed with conditions, such as high blood pressure, that lead to stroke underscore the need for prophylactic care. To prevent stroke and its related debilitating health effects, it is critical that patients who are at risk for stroke receive multidisciplinary care from a team of stroke experts. Physicians at Neurological Surgery PC are committed to partnering with primary care providers to create a comprehensive care team capable of delivering the full spectrum of stroke care. of literature supporting carotid stenting as an equally safe and effective prophy- lactic is growing. T he C a rot id R e v a sc u la r i z at ion Endarterectomy versus Stenting Trial examined the outcomes of symptomatic and asymptomatic patients who were randomized to either carotid endar- terectomy or carotid angioplasty and stenting. The results of the trial showed that carotid stenting outcomes were slightly better for patients younger than 70, and endarterectomy outcomes were slightly better for patients older than 70. The study also illuminated differ- ences in complication rates, which indicates that NSPC specia lists do patients and referring physicians a great service by offering both endarterectomy and carotid angioplasty and stenting for the prevention of stroke. To prevent complications related to either procedure, NSPC physicians evaluate each patient to determine which procedure is ideal. "In terms of unfavorable outcomes, heart attack and stroke can result from both carotid stenting and carotid endar- terectomy, which is why it is critical to weigh the risks and benefits of each pro- cedure, " Dr. Pile-Spellman says. "But the risks involved in each procedure are different and patient-dependent. For example, carotid artery stenting carries a greater risk for stroke and lower risk for heart attack than carotid enda r terectomy, so it's critica l to identify whether patients are at higher risk for cardiac or neurologic com- plications before surgery. If a patient has significant cardiac disease, and his or her anatomy is unfavorable for endarterectomy, then we'll recommend carotid artery stenting." SPECI A L FE AT UR E 1 8 | Long Island MD NEWS ■ M D N E W S . CO M Members of the NSPC care team discuss a patient's chart.