"These patients either responded to medical therapy or were given devices that were less than ideal," Dr. Rosenwasser says. But blood-thinning drugs fail to open blockages in brain arteries in 30 percent of cases, putting patients at high risk for stroke. And even many of those who initially respond to such medications often go on to have another stroke in the next year.
Stroke is the third leading cause of death and disability in the United States, according to Dr. Rosenwasser. He notes that some 80 percent of strokes are due to brain injuries caused by a lack of oxygen, such as those from the buildup of plaque in blood vessels. Only 20 percent are due to hemorrhage.
Dr. Rosenwasser, who is also director of the Division of Cerebrovascular Neurosurgery and Neuroradiology at Jefferson Medical College and Thomas Jefferson University Hospital, pointed out that using other means, such as balloon angioplasty, to push aside plaque, has high complication rates, about 18 to 20 percent.
"What's so exciting here is that we'll begin seeing a host of patients who were never able to be treated before," says Dr. Veznedaroglu. "This is really a revolution for the treatment of this disease and we expect the Wingspan stent to be used frequently."
"The device will allow us to treat more patients up front before they exhaust medical therapy," says Dr. Rosenwasser.
Doctors don't know yet if the stent can be used preventatively. Dr. Veznedaroglu thinks it can. "With a safe stent, I think you'll see eventually that it is better than the best medical management," he says. "But it's just too soon to know. We'll need long-term studies to find out."
The Wingspan stent is not a panacea. Atherosclerotic disease and plaque buildup (as coronary artery disease) can return, he notes, despite a stent. Stents do not stop
Contact: Steve Benowitz
Thomas Jefferson University