Stent Revascularization Safe, Effective for MCA Occlusion
(HealthDay News) – For patients with acute ischemic stroke due to middle cerebral artery (MCA) occlusion who either fail to respond or have contraindications to intravenous thrombolysis (IVT), local intraarterial revascularization with stents is superior to no further therapy, according to research published online Dec. 11 in Radiology.
Martin Roubec, MD, PhD, of the Ostrava University and University Hospital Ostrava in the Czech Republic, and colleagues conducted a prospective, case-control study involving 131 patients with acute ischemic stroke due to MCA occlusion. Seventy-five patients underwent IVT. Patients with MCA recanalization received no further therapy (Group 1), while those with IVT failure were allocated to endovascular treatment (Group 2A) or no further treatment (Group 2B). Patients with contraindications to IVT were allocated to endovascular treatment (Group 3A) or no recanalization therapy (Group 3B).
The researchers found that the rate of MCA recanalization after endovascular treatment was 92.6%. There were significant differences in the rate of favorable outcomes in Groups 2A and 2B (43.5% and 15.4%, respectively) and Groups 3A and 3B (45.2% and 8%, respectively), which was dependent on recanalization of MCA (odds ratio, 5.55).
"We demonstrated that, compared with no further therapy, patients with MCA occlusion who either failed or with contraindication to IVT who undergo revascularization by using intracranial stents achieve superior outcomes," the authors write. "These promising clinical outcomes were seen in the setting of remarkably high rates of recanalization with use of such stents."
Two authors disclosed financial ties to the pharmaceutical industry.