Lifestyle Changes More Effective in Stroke Prevention Than Stenting
Lifestyle changes and medication is said to be safer at preventing stroke than a surgical technique called stenting according to a new study.
"Surgical interventions often have increased risk of complications early on, so we continued to follow the patients to see if the long-term effects of surgery were beneficial," said lead author Colin Derdeyn, MD, professor of radiology at Washington University School of Medicine in St. Louis and director of its Stroke and Cerebrovascular Center at Barnes-Jewish Hospital. "That did not turn out to be the case."
Participation in the SAMMPRIS (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis) examination was stopped two years ago when it was noticeable that stenting was linked to having a higher risk of early strokes and death.
"Each year in the United States, about 800,000 people have a stroke," reported the University. "Physicians think about 10 percent of those strokes result from a narrowed artery inside the brain."
Doctors treat patients who have had strokes with blood thinning medication and drugs to lower cholesterol and blood pressure to prevent clots from forming inside the brain artery.
However new surgical techniques that were thought to be safe were created to improve the blood flow of individuals who suffered from previous stroke. These techniques required surgeons to open clogged arteries in the heart.
"To assess the effectiveness of the new treatments, the SAMMPRIS trial, which was funded by the National Institutes of Health (NIH), enrolled 451 patients at high risk of having a repeated stroke," reported the University. "All participants had a brain artery with at least a 70 percent narrowing that had already caused a stroke or a transient ischemic event (often referred to as a mini stroke)."
For the study, one group of patients underwent the stent surgery while receiving medication to reduce the clot and the other group received the same medications but did not receive stenting.
The groups of participants were suggested by the researchers to engage in more exercise, to stop smoking and improve their diets.Researchers followed up with the patients two to four years after their treatments.
"We were expecting that at some point the incidence of new strokes in those who had surgery would drop below that of those who did not, but that didn't happen," said Derdeyn, who was the neurointerventional principal investigator of the study. "This proves that medical therapy is better than surgery for these patients."
The findings are published in the journal The Lancet.