Stents Do Not Just Prevent, but Can Also Treat Strokes

Stents can be placed inside a stroke victim's brain to treat the stroke as it is occurring, suggests preliminary data from a new study.

Researchers at the State University of New York (SUNY; Buffalo, USA) reported preliminary results on 16 patients who received brain stents as treatment for a stroke as part of a single center Investigational Device Exemption (IDE) from the U.S. Food and Drug Administration (FDA). The researchers first used computed tomography (CT) perfusion to determine if the use of a stent would be beneficial; this helped the researchers tell if the brain was still functional, since some patients experience brain death within an hour, while others can have a viable brain 24 hours after the stroke starts. When that was the case, placing a stent became a feasible option. In those cases where stents were placed, blocked arteries were opened in the brain of all the patients, and 11 patients (69%) had significant improvement in their stroke symptoms. The study was presented at the 21st Annual International Symposium on Endovascular Therapy (ISET), held during January 2009 in Miami (FL, USA).

"Clot-busting drugs only work about half of the time because the blockage can be sticky and adhere to the wall of the artery, making it difficult to break up,” said study presenter Professor L. Nelson Hopkins, M.D., chairman of neurosurgery and professor of radiology at SUNY. "Stents seem to work when clot-busters or other mechanical devices can't.”

Blocked brain vessels are a cause of ischemic strokes, the most common type of stroke. They occur when blood flow to an area of the brain is compromised by a blood clot or blockage. This leads to the death of brain cells and to brain damage. For a long time, efforts to maneuver stents into the brain's delicate vessels to open blockages generally failed, since doctors attempted to use cardiac stents, which were too thick, stiff, and rigid for the narrow arteries deep within the brain. New stents specially designed for the more fragile brain blood vessels are made of a flexible metal alloy that permits it to navigate vessels in the brain. The stent is mounted on a balloon-tipped catheter that guided just beyond the brain blockage; it is then inflated just enough to open up the blockage and deploy the stent.

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