Sunday, September 11, 2011

Medical Treatment: The Key to Stopping Stroke?

BIRMINGHAM, Ala. (Ivanhoe Newswire) -- The key to preventing a common type of stroke may be aggressive medical therapy by itself, rather than in combination with surgery, according to new research.Investigators studied 451 patients aged 30 to 80 who had at least 70 percent narrowing in the arteries in the brain and had experienced symptoms in the past month. Patients in one group were assigned to receive intensive management that involved smoking cessation and blood pressure, cholesterol, diabetes and blood-clot prevention medications. The other group of patients received the same medical treatment but also had balloon angioplasty and a stent procedure.Nearly 15 percent of patients who received stents had a stroke or died within 30 days of enrolling in the study compared to less than 6 percent of patients in the medical therapy group. At one year, about 21 percent of the patients who received the stents had negative effects compared to 12 percent in the medical treatment group.“This study provides an answer to a longstanding question by physicians -- what to do to prevent a devastating second stroke in a high-risk population. Although technological advances have brought intracranial stenting into practice, we have now learned that when tested in a large group, this particular device did not lead to a better health outcome," Walter Koroshetz, M.D., deputy director of the NIH National Institute of Neurological Disorders and Stroke, which funded the clinical trial, was quoted as saying.These results were surprising to the researchers who thought patients receiving stents would fare better. However, they say more studies are needed to determine the long-term benefits of each strategy."The real question is, is there a benefit to patients over the long-term," study co-author and co-principal investigator Brian L. Hoh, M.D., who is an associate professor of radiology and neuroscience in the UF College of Medicine, was quoted as saying. "If you think about it, when people are concerned about stroke, it's not just their first month that matters, so we're waiting to see what the longer-term results will be."Every 40 seconds, someone in the U.S. has a stroke. Stroke is the fourth leading cause of death and a leading cause of disability in the United States. Patients with the type of stroke known as symptomatic intracranial atherosclerosis do not respond well to existing treatments. About one-quarter of them have another stroke within a year.

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