Brain angioplasty and stents found safe and effective for stroke patients
December 11, 2012 in Cardiology
Some stroke patients may benefit from cerebral angioplasty and stent placement, according to a new study published online in the journal Radiology.
"As many as 70 percent of ischemic stroke patients could have positive clinical outcomes with the additional use of intra-arterial revascularization using stents," said Martin Roubec, M.D., Ph.D., a neurologist in the Comprehensive Stroke Center at the University Hospital Ostrava in the Czech Republic.
Ischemic stroke, the most common form of stroke, occurs when blockage in an artery—often from a blood clot or a fatty deposit due to atherosclerosis—interrupts blood flow to an area of the brain. According to Dr. Roubec, only a fraction of European patients experiencing an ischemic stroke are treated with a potentially life-saving drug that can dissolve the clot in a procedure called intravenous thrombolysis (IVT).
"Intravenous thrombolysis must be administered within four and a half hours of the onset of a stroke and cannot be used in patients who are taking anticoagulant medication," said David Školoudík, M.D., Ph.D., associate professor at University Hospital Ostrava. "Because of these limitations, the majority of ischemic stroke patients receive no therapy at all."
The study involved 131 acute ischemic stroke patients treated over a two-year period at two comprehensive stroke centers in Ostrava and Olomouc. The patients, including 74 men and 57 women (mean age 65.8), all had a blockage in the middle cerebral artery detected by computed tomography (CT) or magnetic resonance imaging (MRI).
Seventy-five patients were treated with IVT; 26 (35 percent) of whom achieved a favorable three-month outcome. The remaining 49 patients, for whom IVT failed to re-open the blocked artery, received either cerebral angioplasty/stent placement or no additional therapy.
Of the 23 patients who underwent angioplasty and stenting, 10 (43.5 percent) achieved a favorable three-month outcome. Of the 26 patients who received no more therapy, four (15.4 percent) had a favorable outcome.
The remaining two groups of patients were ineligible for IVT and received either revascularization treatment or received no further therapy. Of the 31 patients who underwent angioplasty and stent placement, 14 (45.2 percent) achieved a favorable outcome. Of the 25 patients who received no therapy, two (8 percent) had a favorable outcome.
To perform the revascularization procedure, the physicians used an imaging technique called digital subtraction angiography to visualize the blood vessels and a guide wire to maneuver a balloon-tipped catheter to the location of the blockage in the middle cerebral artery. Once the balloon was inflated, deflated and withdrawn, a stent was inserted to help the artery remain open. Patients with a favorable three-month outcome following the procedure were able to live independently and perform normal daily activities.
"We demonstrated that in patients with middle cerebral artery blockage after IVT failure or for whom IVT is contraindicated, revascularization with stents is superior to providing no further therapy," Dr. Roubec said.
More information: "A Controlled Trial of Revascularization in Acute Stroke." Radiology, 2012.
Journal reference:
Radiology
Provided by
Radiological Society of North America
-
Stroke therapy window might be extended past nine hours for some
Feb 09, 2009 |
not rated yet |
0
-
The Medical Minute: Solitaire for stroke -- It's not a game
May 22, 2012 |
not rated yet |
0
-
Individualized stroke treatment available for patients, though underutilized
Mar 26, 2009 |
not rated yet |
0
-
Patients who wake up with stroke may be candidates for clot-busters
Mar 12, 2009 |
not rated yet |
0
-
Using CT, radiologists can pinpoint cause of some strokes
Nov 09, 2010 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Question in reflection and transmission at oblique incidence.
4 hours ago
-
Is this plasma (picture in thread)
4 hours ago
-
Basic physics understanding. Could someone explain?
6 hours ago
-
Change in flux of a transformer
7 hours ago
-
Electric field between parallel plate capacitor
7 hours ago
-
Why angle of projectile has 2 solutions?
8 hours ago
- More from Physics Forums - Classical Physics
More news stories
Registry confirms TAVI efficacy and safety in Asian patients
Transcatheter aortic valve implantation (TAVI) is effective and safe in Asian patients, according to early experience based on first results from a multicentre Asian registry reported at EuroPCR 2013.
Cardiology
10 hours ago |
not rated yet |
0
Diagnostic coronary angiography: Functional flow reserve changes decisions in 25 percent of cases
Routinely measuring fractional flow reserve (FFR) using pressure wire assessment during coronary angiography for diagnosis of chest pain leads to significant changes in the management of one in four patients, according to ...
Cardiology
13 hours ago |
not rated yet |
0
Feasibility trial reports deployment of new device for TAVI in aortic insufficiency
A new investigational device - the Helio System (TF-FA) - being developed for use with the Sapien XT Transcatheter Heart Valve was successfully deployed in all four patients in a small, first-in-human feasibility study of ...
Cardiology
13 hours ago |
not rated yet |
0
Cardiac study used as source for new guidelines on treating people undergoing coronary artery bypass surgery
Cardiac research from the University of Alberta had serious impact as a source for the American College of Cardiology and the American Heart Association's new guidelines on how to treat patients undergoing coronary artery ...
Cardiology
14 hours ago |
not rated yet |
0
Dual-source cardiac CT IDs CAD in hard-to-image patients
(HealthDay)—In patients who have previously been considered difficult to image, dual-source cardiac (DSC) computed tomography (CT) can identify clinically significant coronary artery disease, according ...
Cardiology
May 23, 2013 |
not rated yet |
0
Engineered cytomegalovirus protects monkeys from HIV equivalent
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
Researchers identify first drug targets in childhood genetic tumor disorder
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
Hormone levels may provide key to understanding psychological disorders in women
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
Going live: Immune cell activation in multiple sclerosis
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
Driving and hands-free talking lead to spike in errors, study shows
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
Depression raises diabetics' risk of severe low blood sugar episodes
(Medical Xpress)—Patients with diabetes who are depressed are much more likely to develop episodes of dangerously low blood sugars, or hypoglycemia, than are those who are not depressed, a new study has ...