Stent-Assisted Angioplasty Aids Stroke Symptoms

A study has shown that stent-assisted angioplasty may alleviate symptoms, increase blood flow to the brain, and improve the prognosis of patients with stroke symptoms from arterial blockages in the rear of the brain. The retrospective study was published in the June 2001 issue of Neurosurgery.

The study was conducted by researchers from the University of Pittsburgh (UPMC, PA, USA) and the University of Texas Southwestern Medical Center (Dallas, USA). The researchers examined the outcomes of 11 patients with stroke symptoms who underwent angioplasty and stenting of either the vertebral or basilar arteries. All of the patients had transient ischemic attacks or fixed deficits that failed to respond to medical treatment. Symptoms included headache, facial droop, loss of coordination, vertigo, and depression. After a follow-up of four months, seven of the patients no longer had recurrent symptoms, lived at home, and resumed activities at the same or better levels than before. The remaining four patients died either from complications during the procedure or several months later.

The researchers note that for surgical management of basilar or vertebral stenosis, the combined mortality and morbidity rate is 34%, while angioplasty of these arteries without stenting leads to restenosis in 20-30% of patients. Recent advances in stent technology have led to the development of a new generation of stents that allow neuroradiologists to better negotiate the arteries in the back of the neck.

"Although this study demonstrates the potential for stent-assisted angioplasty, it also demonstrates the risks associated with dilation of stenotic, often fragile, diseased vessels,” said Michael Horowitz, M.D., UPMC associate professor in the department of neurological surgery and radiology. "Long-term follow-up is needed to determine whether this treatment will improve on the natural history of the disease with medical management alone.”





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