Research led by Washington University confirms that medication and lifestyle changes are safer and more effective at preventing certain strokes than surgery.
Most strokes are caused by a reduction in blood flow to the brain ― usually from a blocked artery in the heart or neck. In about a tenth of cases, a narrowed brain artery is to blame.
In this study, patients with narrowed brain arteries took medication to reduce blood clots, and to lower blood pressure and cholesterol ― all risk factors for stroke.
They were encouraged to exercise, improve their diets and stop smoking.
Half of the study participants also underwent a surgical procedure known as stenting, in which a metal mesh tube is used to prop open the damaged artery.
Washington University neuroradiologist and study lead researcher Colin Derdeyn said they expected the patients with stents to do better.
“We were very disappointed to learn that doing this angioplasty and stenting procedure of the narrowed brain arteries had higher risk than treating these people with medical therapy,” Derdeyn said.
The stent surgery increased the patients’ risk of stroke or death.
But Derdeyn said the medical treatment worked better than expected.
“The stroke risk in the medical group was almost half of what we thought it was going to be based on our prior experience,” Derdeyn said. “And we’re convinced that that is because of being aggressive in managing these risk factors.”
This multi-center study was funded by the National Institutes of Health. The latest results are published in the medical journal The Lancet.
Every year, almost 800,000 people in the U.S. have a stroke. About 10 percent are caused by narrowed brain arteries.
Follow Veronique LaCapra on Twitter: @KWMUScience
