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Meds Better Than Stent for Preventing Second Stroke: Study
Date:9/7/2011

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Sept. 7 (HealthDay News) -- Stroke patients who receive aggressive medical therapy have a better chance of avoiding a second stroke than those who receive medical therapy plus a stent in the brain, a new study reveals.

The difference is so significant that a trial was stopped early because data showed patients who received stents died more often and had more strokes than those treated with medical therapy alone.

"We hypothesized that stenting would be more effective than medical therapy and found exactly the opposite," said lead researcher Dr. Marc I. Chimowitz, a professor of neurology at the Medical University of South Carolina.

"In this population, given the results of the study, I would recommend aggressive medical management," he said.

There may be a place for stenting in patients who don't respond well to medical therapy alone, Chimowitz added. However, he has stopped doing the procedure since seeing the results of this trial, called the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study.

The report was published in the Sept. 7 online edition of the New England Journal of Medicine.

For this trial, researchers randomly assigned 451 stroke patients to aggressive medical treatment or medical treatment plus a brain stent. The researchers anticipated that stenting would reduce the risk of recurrent stroke or death by 35 percent over two years.

The patients were between 30 and 80 years old and in the highest risk category for stroke, with blockage or narrowing of arteries of 70 to 99 percent. Most patients with less severe blockage receive medical therapy alone as a matter of course, the researchers noted.

Among those receiving stents, 14.7 percent died or had a stroke within a month after treatment, compared with 5.8 percent of those who received medical therap
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