Disadvantages of stenting after a stroke

Scientists have proven that aggressive drug therapy gives a greater chance of survival when it is combined with stenting.

A stroke is an acute disorder of the cerebral circulation which damages brain cells. Stroke causes blockage (ischemia) or rupture (bleeding) of a vessel which carries blood to parts of the brain. The most common complications of a stroke include numbness, weakness, paralysis, speech disorders, vision problems, poor coordination and severe headache. Treatment is a complex multi-stage process. It includes first aid during the first seconds after the stroke has occurred to prevention of recurrence in the post-rehabilitation period.

Even taking into account the huge compensatory capabilities of the brain, the full restoration of lost functions of the patient is very problematic. Prevention of recurrent strokes is one of the main focuses for patients who had suffered a stroke. When a stroke was caused by stenosis of the carotid or vertebral arteries, doctors resort to stenting to improve the blood supply to the brain. A stent is a special device in the form of a cylinder, placed in the lumen of hollow organs. It widens the narrowed areas.

Studies have shown that stenting increases the risk of a second stroke by 100% more than traditional medical treatment does. Scientists think that changing lifestyle and also taking hypertensive, blood thinning medicines and also medicines that lower cholesterol levels helps to treat the disease much more effectively and help prevent a second stroke.

The study involved 450 patients (aged between 30 to 80 years of age) who had recently had a stroke or who had narrowing of the main arteries of the brain by 70-90%. All of them were taking blood thinning medications and drugs to control the blood pressure and cholesterol level. 225 patients from this group received stenting into the cerebral arteries. 15% of 225 people had a second stroke or fatal outcome within 30 days of the onset of the disease. 20.5% had a stroke or fatal outcome 1 year later. Patients who had received only medication, about 6% suffered from stroke or died within 30 days, and 11.5% - within 1 year.

The next step in the study is to identify that groups of patients for whom stenting is necessary to improve their health condition. Additionally, scientists are trying to understand why stenting produces such effects. They assume that blood clots are accumulating on the stents, then they detach from the stents causing a repeated stroke and leading to a fatal outcome. Another reason may be the wrong installation of stents.

That is why scientists recommend to first resort to drug treatment to prevent a second stroke. Stenting can be possible in case medication proved ineffective and stenting should be used only after prescription of a qualified specialist.

Also see other articles on this topic:

• Depression is a risk factor for stroke
• The consequences of a stroke and rehabilitation
• Pradax for stroke prevention

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