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Study Supports Use of 'Brain Stents' for Certain Stroke Patients
Date:12/11/2012

/stenting and in 8 percent of those who received no further treatment.

The study was published online Dec. 11 in the journal Radiology.

For patients with this type of arterial blockage who cannot receive clot-busting drugs or do not benefit from them, re-opening the vessel "with stents is superior to providing no further therapy," Roubec said in a journal press release.

Two experts in the United States stressed that the usefulness of this approach is still being debated.

Dr. Keith Siller is medical director of the Comprehensive Stroke Care Center at NYU Langone Medical Center in New York City. He noted that although the Czech trial found a real benefit for patients with ischemic stroke, another trial (known by the acronym SAMMPRIS), "concluded that patients with recent stroke and [mini-strokes] from longstanding blockages in brain arteries had worse outcomes with angioplasty and stenting compared to using standard medications (aspirin, clopidogrel, statin) combined with aggressive risk-factor modification (exercise, diet, etc.)."

However, Siller -- who is also assistant professor at the NYU School of Medicine -- said the Czech trial used similar stents but focused on "a slightly different" and less easily managed subset of patients who "are known to have the worst outcomes if their arteries remain blocked."

He believes that for these patients, "Roubec's report clearly shows that in experienced hands, angioplasty and stenting led to better clinical outcomes and less hemorrhagic complications with results that were superior to the patients in SAMMPRIS."

The bottom line, for Siller: Angioplasty plus stenting may have a role for these worst-case patients, but the approach is "still unproven in less urgent scenarios where the goal is preventing recurrence in the near future."

Another expert agreed.

"Based on the study, stenting in the acute stroke setting may be an option for patients that have contraind
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