Major brain stent study: Experts say procedures effectively for some patients
Also included in: Neurology / neuroscience
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An article in the New England Journal of medicine, says report on national institutes of health research on brain of stents, that aggressive treatment without Stenting better for high-risk patients.
But experts at the Cedars-Sinai Medical Center, who believe in the study, that this is suitable for some patients. You express concern that those who could benefit from minimally invasive placement of a mesh tube or stent blocked brain arteries open from this report can be discouraged. They say this study is a helpful start, and concerns about multiple study but not likely to understand the last word when Stenting may be appropriate, restrictions and exclusions.
"Get far greater than those generally patients in the study of received aggressive management of risk factors." Only with these heroic measures benefit the type of average patients, as have the study, ", says Patrick D. LYD, MD, Chairman of the Department of Neurology and Carmen and Louis Warsaw Chair of Neurology at Cedars-Sinai, expert on medical intervention and management of the stroke."
Michael j. Alexander, MD, Professor and clinical Chief of the Department of neurosurgery, and Director of Neurovascular Cedars-Sinai Center comments: "for certain patients - in particular for the drugs are not effective - most experts believe Stenting is a viable option." "We have many patients had had dramatic, immediate improvement in neurological function after intracranial stenting."
LYD and Alexander, the Cedars-Sinai led part of the clinical trial of 50-Center, expressed concern about this study including: sicker patients - such as those with multiple blockages of arteries or long blocks - were excluded; Some patients are probably benefit stenting. Most patients in the study had blockages in smaller arteries, which are more difficult to treat with stenting. "It is common in clinical trials of interventionellen or surgical procedures for patients of treatment to a higher rate of event" "have in the first 30 days." Long-term results provide more valid information. "Angioplasty and stenting has become commonplace in the treatment of blocked heart arteries, but Stenting in the brain is more difficult, because cerebral arteries are more sensitive than that of the heart," said Alexander, Member of the first NIH Steering Committee for this study. Evaluated the wingspan stent - the study - designed to more flexible too fragile cerebral arteries will start.
"This is the first study, which closely analyzed patient outcomes with intracranial Stenting longer-term." First trials with coronary (heart) Artery Stenting and Carotid Artery Stenting also were not very successful. However, as we could, to determine which patients are the best candidates for these treatments, and the technology has improved, they become very successful. I think the same is true of the intracranial Artery Stenting it, "Alexander said.
Alexander has more than 500 intracranial Stenting procedures and was involved in early testing of the device in the study, intrakranialer angioplasty and stenting system used gateway span. He is a consultant and device Proctor for Stryker Neurovascular, manufacturer of the gateway balloon and wingspan stent. He has no other financial interest in the company.
The device is approved by the food and drug administration.
The New England Journal of Medicine article is on the Stenting vs. aggressive medical management for recurrent stroke study, prevent in intracranial stenosis (SAMMPRIS) funded by the National Institute of neurological disorders and stroke, part of NIH.
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