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Stroke prevention trial finds intensive medical treatment has better results than brain stenting
Date:9/8/2011

and we need to get into battle mode immediately," said Dr. Sila, who is also Professor of Neurology at Case Western Reserve University School of Medicine.

The study, named Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS), was a trial of patients with a narrowing of the arteries in the brain due to atherosclerosis who had suffered a stroke and were at high risk for another stroke based on the location and the severity of the blockage and the instability of the plaque.

In addition to the intensive medical program, half of the patients in the study received an intervention of a self-expanding stent that widens a major artery in the brain and facilitates blood flow. One possible explanation for the higher stroke rate in the stented group is that patients who have had recent stroke symptoms sometimes have unstable plaque in their arteries which the stent could have dislodged, the study authors suggest. The study device, the Gateway-Wingspan intracranial angioplasty and stenting system, is the only system currently approved by the U.S. Food and Drug Administration (FDA) for certain high-risk stroke patients. The authors noted that although similar stenting systems that do not have FDA approval are being used in clinical practice, they did not evaluate those devices in this study

Dr. Sila said, "Based on prior studies, it was estimated that the rate of stroke and death at 30 days in this high risk group would be about 11 percent. The group that received aggressive medical therapy alone did far better than predicted with a 30 day stroke and death rate of only 5.8 percent. However, the group that received a stent as well as aggressive medical therapy did worse than predicted with a rate of 14.7 percent.

She said that stroke and death events continued to occur over a short follow-up period, less than one year, with the rate in medical therapy alone increasing to 12.2 perce
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Contact: George Stamatis
george.stamatis@uhhospitals.org
216-844-3667
University Hospitals Case Medical Center
Source:Eurekalert

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