TIA (transient ischemic attack) and stroke: neurologists for more precise patient selection for stent treatments

After a transient ischemic attack (TIA) or stroke, clinically stable patients do not appear to benefit from treatment with a stent. However, this may not be true for high-risk patients. This is shown by a Chinese-American study now published in the Journal of the American Medical Association (JAMA) (DOI: 10.1001/jama.2022.12000).
The results of the new study confirm those of studies published eight years ago: In patients with intracranial stenoses who are in a clinically stable condition, stents provide no additional benefit.
An indication for stent implantation is seen in patients with intracranial stenosis with a degree of stenosis of at least 70 percent who have suffered at least one further infarction after a stenosis-related infarction despite subsequent intensive drug therapy.

“Not treating affected patients with progressive neurological symptoms at all because of a lack of data and waiting until a subsequent event occurs still seems questionable to us” (Diener). What is needed, on the other hand, is more precise patient selection so that those affected can receive therapy in a timely manner, the expert said.
“A second event should be prevented and not waited for as an indication criterion” (P Berlit).

Author(s) Source
hil/aerzteblatt.de aerzteblatt.de 09.09.2022 (german)
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