Brain Stent for Older Stroke Patients
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David Fiorella
M.D., Ph.D. |
At one time or another we’ve all experienced the frustration of lacking the right tool for doing an intricate repair job or trying to make do with “the next best thing.” So it’s easy to relate to the enthusiasm in Dr. David Fiorella’s voice and his animated description of how the new Wingspan Stent System can improve the prognosis and quality of life for stroke patients whose brain arteries have become clogged. Commonly used to treat blocked arteries in the heart, stents are wire-mesh tubes that restore blood flow in blocked vessels.
Studies have shown that without this intervention, more than 20 percent of a certain population of patients - typically elderly patients who have not responded to conventional treatment such as aspirin or blood thinners - will have another stroke within a year. “It’s evident these patients need to have better options for treatment,” explains David Fiorella, M.D., Ph.D., a Cleveland Clinic interventional neuroradiologist.
Cleveland Clinic is among a select few hospitals around the nation to begin using the Wingspan Stent System to open up clogged brain arteries in adults. During the procedure, this stent system is inserted into the femoral artery in the leg and guided just beyond the blockage in the brain. A tiny balloon is inflated just enough to crack open the plaque and deploy the stent. Specially designed for fragile blood vessels in the brain, the stent is made of a flexible metal alloy. “It is self-expanding, opening up gently against the vessel wall so there is less chance of plaque being dislodged,” says Dr. Fiorella. “It’s fantastic.”
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Wingspan stent placed in brain blood vessel
Image courtesy of Boston Scientific |
Dr. Fiorella explains that until Wingspan, there were “no really good options” for these patients, and physicians faced the daunting task of inserting cardiac stents into small, delicate brain blood vessels. “Maneuvering inside these narrow arteries also is much more dangerous,” says Dr. Fiorella.
The United States Food and Drug Administration granted expedited approval to the manufacturer to launch use of the Wingspan Stent, under what is termed a “humanitarian-device exemption.” This exception is granted when there are no other devices for treating a specific condition and the patient population numbers less than 4,000 per year.
The stent has only been used on stroke patients who have symptoms such as body weakness, double vision and speech difficulty. Thus far, all eight patients who have received the Wingspan Stent at Cleveland Clinic have recovered without complication.
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