Aggressive use of cardiovascular drugs is much more effective in preventing a recurrence of stroke than deploying a stent to prop open narrowed arteries in the brain, a U.S. government-funded study reports.
The study, published by the New England Journal of Medicine, looked at patients who had already suffered a stroke or a mini-stroke. Adding Stryker Corp.'s Wingspan stenting system to medication management for stroke did not improve survival in high-risk patients, researchers found.
Researchers studied 451 patients in 50 medical centers who recently had a stroke or stroke-like symptoms caused by narrowing of a major brain artery.
Everyone in the study was given blood-thinning drugs and treatments to lower blood pressure and cholesterol, two key risk factors for stroke. Half the patients were also treated with stents.
The study was called Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis or SAMMPRIS
The story isn't entirely that stenting is bad, said Colin Derdeyn, an interventional neuroradiologist at Washington University, St. Louis, and a co-author of the study.
The stent called Wingspan, marketed by a unit of Stryker Corp., is a self-expanding device for obstructed arteries in the brain. Researchers estimate 90,000 U.S. patients a year suffer strokes related to blockages in such arteries, many of them potential candidates for the device.
The Food and Drug Administration approved the stent six years ago on the basis of a humanitarian exemption, which did not require solid evidence that it would prevent strokes.
Stroke is the fourth-leading cause of death and a leading cause of disability in the United States.
Past studies on stents lead the researchers to believe that procedure would be the most beneficial. Experts say this study will change the way doctors treat stroke patients.