Feature | December 28, 2012

Brain Angioplasty, Stents Found Safe and Effective for Stroke Patients

Cerebral Angioplasty Stents Radiology Stroke treatment devices

December 28, 2012 — Some stroke patients may benefit from cerebral angioplasty and stent placement, according to a new clinical 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 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 guidewire 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,” Roubec said.

Collaborating with Roubec and Školoudík were Martin Kuliha, M.D., Václav Procházka, M.D., Ph.D., Jan Kraj?a, M.D., Daniel Czerný, M.D., Tomáš Jonszta, M.D., Antonín Krajina, M.D., Ph.D., Daniel Ša?ák, M.D., Ph.D., F.E.S.O., Kate?ina Langová, M.S., Ph.D., and Roman Herzig, M.D., Ph.D., F.E.S.O.

For more information: www.radiologyinfo.org

Related Content

Neuravi, EmboTrap II stent retriever, thrombectomy device, acute stroke, European launch, CE Mark
News | Thrombectomy Devices| September 28, 2016
Neuravi recently announced Conformité Européenne (CE) Mark approval and launch of the company’s newly available...
Infinix 4D CT

Toshiba's Infinix 4D CT, which combines CT with angiography in the interventional lab.

Feature | Angiography| September 28, 2016 | Tom Watson BS, RCVT, Clinical Analyst, MD Buyline
One of the more significant advancements for interventional X-ray (IXR) in the past few years has been a significantl
TCT 2016, TCT.16, main arena, late breaking trials
Feature | Cath Lab| September 28, 2016
September 28, 2016 — The Cardiovascular Research Foundation (CRF) has announced the 11 late-breaking trials and 16 fi
Avinger, U.S. Department of Veterans Affairs, VA, Lumivascular technology, FSS Contract Award
News | Optical Coherence Tomography (OCT)| September 27, 2016
Avinger Inc. recently announced the company has received an FSS Contract Award from the U.S. Department of Veterans...
Bard, Lutonix 014 DCB, drug-coated balloon, six-month endpoint, FDA IDE trial
Technology | Drug-Eluting Balloons| September 26, 2016
C. R. Bard Inc. announced the U.S. Food and Drug Administration (FDA) approved an Investigational Device Exemption (IDE...
smartphones, hospital tranfers, heart attack patients, JACC study, South Korea
News | Mobile Devices| September 23, 2016
Smartphone communication among medical teams at different hospitals can significantly reduce the time it takes for...
Robert M. Califf, FDA commissioner, future of cardiovascular medicine, JACC column
News | Business| September 23, 2016
Technology advances coupled with increased use of social media and personal devices could offer new possibilities for...
Medtronic, In.Pact Admiral drug-coated balloon, trial data, VIVA
News | Drug-Eluting Balloons| September 22, 2016
New data presented at the Vascular Interventional Advances (VIVA) conference demonstrated the durability, consistency...
4Tech, TriCinch TTVR, transcather tricuspid valve repair device, first implant
News | Heart Valve Technology| September 22, 2016
4Tech Inc. announced that its TriCinch device has been used in the world’s first-ever successful transcatheter...
Transesophageal Echo, TEE. Interventional echocardiography, interventional echo, Philips, CX50

Transesophageal echo (TEE) has become an essential part of the new transcatheter structrual heart therapies, giving rise to a new sub-speciality of interventional echocardiography.  

Feature | Cath Lab Navigation Aids| September 21, 2016 | Dave Fornell
The rapid growth of transcatheter structural heart procedures and the need for increased use of echocardiography as a
Overlay Init