Medication more effective than stenting in stroke patients, study finds

[bemildred]

People at high risk of suffering a second stroke appear to fare better on a meticulous regimen of medications rather than having surgery to insert an artery-opening stent in the brain, according to a new report.

The results of the study on how to best treat a narrowing of brain arteries, called stenosis, surprised researchers who had expected stenting to be the superior treatment, and the much higher incidence of second strokes and deaths in patients who received stents led to the early termination of the study in April.

The results, published online Wednesday by the New England Journal of Medicine, should lead to immediate changes in medical practice, experts said. Stenting to prevent a second stroke, formally known as percutaneous transluminal angioplasty and stenting, has become popular in the last few years, although it's not covered by Medicare.

"The most intuitive thing is to fix the blood vessel and get rid of the narrowing. That is what the trial was intended to show," said Dr. Walter Koroshetz, deputy director of the National Institute of Neurological Disorders and Stroke, who oversaw the study. "It doesn't always turn out that that is the best thing for the patient. And that is what happened here."

http://www.latimes.com/health/la-he-stroke-stent-20110907,0,243627.story