Brain Stent Treatment Should Not Be Used for Strokes, Study Says

Stroke patients who receive a stent to open an artery to the brain are at greater risk of another stroke or death, a new study shows.

In a clinical trial of 450 patients, the half who received brain stents suffered additional strokes or death at rates more than double compared to the non-stented patients.

The stents were considered so risky that the National Institute of Neurological Disorders and Stroke stopped enrolling patients in the trial in April. The National Institutes of Health released a warning to doctors.

Based on the study, the standard of care for these high-risk patients with strokes is expected to switch to lifestyle changes and drug therapies that can lower blood pressure and cholesterol and reduce the risk of clots.

"The complications on the stent side of the trial were higher than we expected," said co-principal investigator Dr. Colin Derdeyn, professor of radiology at Washington University in a statement. "Further research may identify specific groups of patients who may benefit from these stents, but for now we seem to be able to save more lives by aggressively working to lower blood pressure and cholesterol."

The study is reported in the latest New England Journal of Medicine.

The patients in the study had recent strokes that were linked to severe stenosis, a blockage or narrowing of major arteries in the brain. Stenosis is attributed to 50,000 of the 795,000 strokes a year in the U.S.

While all of the patients received blood-thinners and drugs for blood pressure and cholesterol, half were chosen to recieve stents.

Close to 15 percent of patients who got stents had another stroke or died within the first month after the procedure. Fewer than 6 percent in the group that did not receive stents had another stroke or died.

After a year, the stroke or death rate was 21 percent for patients with stents and 12 percents for the control group patients.

Researchers speculated that stent patients may have done worse because their blood vessels were damaged when the stent was inserted, clots were loosened by the stent or blood clots formed on the stents.