Meds, lifestyle change more effective than stroke prevention surgery
Washington: A new study has claimed that medication and lifestyle changes are much safer and effective at preventing stroke than a surgical technique called stenting.
The study was led by researchers at Washington University School of Medicine, the Medical University of South Carolina, Emory University and the State University of New York at Stony Brook.
To assess the effectiveness of the new treatments, the SAMMPRIS ( Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis) trial, which was funded by the National Institutes of Health (NIH), enrolled 451 patients at high risk of having a repeated stroke.
All participants had a brain artery with at least a 70 percent narrowing that had already caused a stroke or a transient ischemic event (often referred to as a mini stroke).
Participants were divided into two groups. In one group, each participant had a metal stent surgically inserted into the narrowed brain artery to open it up.
Each also received strong medications to reduce clot formation and lower cholesterol and blood pressure. Participants in the second group received the same medications but did not receive stent implants.
Both groups were contacted regularly by lifestyle modification coaches, who encouraged participants to exercise more, stop smoking, improve their diet and lose weight.
For the final analysis, the scientists followed the patients for at least two years after treatment. Some patients were followed for as long as four years.
Lead author Colin Derdeyn, MD, professor of radiology at Washington University School of Medicine in St. Louis and director of its Stroke and Cerebrovascular Center at Barnes-Jewish Hospital, said that they were expecting that at some point the incidence of new strokes in those who had surgery would drop below that of those who did not, but that didn't happen, which proves that medical therapy is better than surgery for these patients.
The study has been published in journal The Lancet.