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

Videos | Stents | September 11, 2018
This is an animation showing how the dedicated bifurcation stent developed by Advanced Bifurcation Systems (ABS) is d
Elixir Medical Corporation Unveils Transformational DynamX Stent Featuring Adaptive Segments that Uncage the Stented Artery
News | Stents | January 25, 2018
January 25, 2018 – Elixir Medical Corporation, a leader in the development of breakthrough adaptive remodeling techno
The TIDES-ACS results show us that the Optimax stent is noninferior in patients with acute coronary syndrome compared to Synergy.

The presentation of the ESC late-breaker TIDES-ACS results show us that the Optimax stent is noninferior in patients with acute coronary syndrome compared to Synergy.

News | Stents | November 24, 2017
November 24, 2017 – During a late-breaking session at the European Society of Cardiology (ESC) 2017 meeting, presente
News | Stents | November 10, 2017
Cordis, a Cardinal Health company, recently unveiled a comprehensive interventional cardiology portfolio, which now...
OCT comparison between the Combo vs. Xience stents in the HARMONEE study.

OCT comparison between the Combo vs. Xience stents in the HARMONEE study.

Feature | Stents | November 08, 2017
November 8, 2017 – New results from the HARMONEE Japan/U.S.
FDA Approves COBRA REDUCE Trial of 14-Day DAPT With CeloNova Stent
News | Stents | October 27, 2017
CeloNova BioSciences Inc. announced the U.S. Food and Drug Administration (FDA) approved expansion of CeloNova's...
CeloNova Cobra Pzf stent
Technology | Stents | March 02, 2017
March 2, 2017 — The U.S. Food and Drug Administration (FDA) cleared CeloNova BioSciences Inc.
OCT, intravascular imaging, stent, good stent apposition on vessel wall, TRANSFORM-OCT study

An OCT image showing good stent strut apposition against the vessel wall.

News | Stents | January 13, 2017
January 13, 2017 — Results from TRANSFORM-OCT, a prospective, randomized trial using optical coherence tomography (OC
EXCEL Trial, TCT 2016, drug-eluting stents, CABG, surgery left main heart disease, LMCAD

Gregg W. Stone, M.D., presenting the EXCEL data at TCT 2016 during a standing room only late-breaking trial session.

Feature | Stents | January 12, 2017 | Dave Fornell
The biggest news from the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting this past fall was the results
Biotronik's Osiro stent, prison IV trial

Biotronik's Osiro ultra-thin strut, sirolimus-eluting stent.

News | Stents | November 09, 2016
November 9, 2016 – Results from a randomized, multicenter trial failed to show non-inferiority of hybrid, ultra-thin
Overlay Init