Is angioplasty and stenting surgery effective in preventing stroke?

This study looked at the impact of angioplasty and stenting surgery in preventing stroke among patients with blocked cerebral arteries (arteries that supply the brain). 

A stroke occurs when there is a disturbance of blood supply to a part of the brain. This can be caused by a blood clot in the brain (ischemic stroke) or a burst blood vessel (hemorrhagic stroke). Both types of stroke result in a lack of oxygen and food reaching the brain tissue and can cause brain damage. What makes a person vulnerable to stroke is if they have a buildup of plaque, such as cholesterol, inside the wall of an artery that supplies the brain with blood, such as the middle cerebral artery. A build up of plaque narrows the space within the artery and reduces blood flow to the brain, thereby causing a stroke.

Angioplasty and stenting is a minimally invasive surgery that widens the diameter of an artery, restoring blood flow and reducing the risk of stroke. It involves the insertion of a small flexible tube into an artery (stent), normally in the groin, and the tube is moved along the blood system until it reaches the narrowed artery. A small balloon (angioplasty) is then inflated within the artery to dilate it and flatten the plaque against the artery wall. This type of surgery is regularly performed to widen arteries that supply the heart in order to help prevent a heart attack; however, its use in arteries that supply the brain is less common. 

This study investigated the impact and safety of stenting and angioplasty surgery on preventing stroke among people with blocked middle cerebral arteries.

The study included 155 patients who underwent angioplasty and stenting surgery. The frequency of stroke or death within 30 days after surgery was 8.4% (13 out of the 155 patients). Among these 13 patients, 4 patients had a non-fatal ischemic stroke and 9 patients had a brain hemorrhage, which caused 4 deaths. Up to 20 months after the initial 30 days it was found that 2 patients had a recurrent stroke. Serum albumin (a protein found in blood) could be a predictor of hemorrhagic stroke. 

The study concludes that stenting and angioplasty is safe and effective in preventing stroke among patients with blocked cerebral arteries. 

The study was carried out from 2004 until 2013 but there were some changes in how the study was carried out over the course of this period. Therefore the accuracy of the study is affected.    

If you or someone you know have a narrowed cerebral artery due to plaque build up and are at risk of having a stroke, talk to a doctor about angioplasty and stenting surgery, which this study has shown can reduce the occurrence of stroke for up to 20 months.