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Stenting shows promise as stroke treatment
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Stenting was an effective and safe treatment strategy for patients with acute ischemic stroke in a study of more than 100 patients.
“As many as 70% of ischemic stroke patients could have positive clinical outcomes with the additional use of intra-arterial revascularization using stents,” Martin Roubec, MD, PhD, neurologist at the Comprehensive Stroke Center at the University Hospital Ostrava in the Czech Republic and trial investigator, said in a press release.
The prospective, bi-center, case-control study included 131 patients (mean age, 65.9 years) with acute ischemic stroke caused by middle cerebral artery occlusion, of whom 75 patients underwent IV thrombolysis (IVT). Patients were allocated to groups as follows: IVT-treated patients with middle cerebral artery recanalization (group 1; n=26); patients with IVT failure after 60 minutes allocated to endovascular treatment (group 2A; n=23) or no further therapy (group 2B; n=26); patients with contraindication to IVT allocated to endovascular treatment within 8 hours since onset of acute ischemic stroke (group 3A; n=31) or to no recanalization therapy (group 3B; n=25).
Martin Roubec
Roubec and fellow researchers reported that symptomatic intracerebral hemorrhage occurred in one patient in each group, equating to 3.8% of patients in group 1; 4.3% of patients in group 2A; 3.8% of patients in group 2B; 3.2% of patients in group 3A; and 4% of group 3B (P>.05).
Middle cerebral artery recanalization after endovascular treatment was achieved in 50 of 54 (92.6%) patients.
Favorable outcome, defined as modified Rankin scale score 0 to 2 at 3 months after stroke onset, significantly differed between groups 2A and 2B (43.5% vs. 15.4%; P=.03) and groups 3A and 3B (45.2% vs. 8%; P=.004) and was dependent on middle cerebral artery recanalization (OR=5.55; P=.006).
“These findings indicate that patients who do not respond to or have a contraindication to IV [thrombolysis] should be offered local revascularization therapy [with intracranial stents],” Roubec and colleagues wrote.
Disclosure: Roubec reports no relevant financial disclosures.
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