"Angioplasty improves the outcome over what we would expect to see with medication alone," said study author Michael P. Marks, M.D., associate professor of radiology and neurosurgery and chief of interventional neuroradiology at Stanford University Medical Center in Palo Alto, Calif. Additionally, "Stent treatment may not be necessary."

The study was not a head-to-head comparison of angioplasty and medical therapy. Researchers used data from other studies to make risk comparisons.

Angioplasty uses a tiny balloon threaded into the area of blockage. Once in this area, the balloon is inflated. As it expands, it forces the fatty plaque against the artery wall, opening the vessel. Balloon angioplasty is widely used to open blocked heart arteries but is not as commonly used for clearing neck and brain arteries. In some cases, a miniature wire tube called a stent is left behind after angioplasty to keep the artery propped open.

Blood thinners such as aspirin and anticoagulants such as warfarin are standard medical therapy for clogged brain vessels. Anticoagulants interfere with the blood's ability to clot.

The study examined both the overall rate of stroke and the rate of stroke in areas supplied by the treated vessel in patients with symptomatic intracranial stenosis (narrowing of a brain blood vessel) undergoing angioplasty.

Researchers studied 36 patients with significant intracranial stenosis, all of whom had unsuccessful medical therapy. Before angioplasty stenosis averaged 84.2 percent. After angioplasty, stenosis averaged 43.3 percent.

One ischemic stroke occurred during angioplasty but the patient recovered. No other ischemic strokes occurred within one month of angi
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
5-Feb-2004