AANS Neurosurgeon | Volume 27, Number 3, 2018

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Surgery Technique Reduces Strokes in Atherosclerosis Patients

Late-Breaking Findings From Phase IIa Clinical Trial Are Presented at World Stroke Congress in Montreal

A surgical technique called EDAS (encephaloduroarteriosynangiosis) significantly decreases the rate of stroke recurrence and death for patients with severe atherosclerosis of the brain arteries, according to findings of a Phase IIa clinical. Atherosclerotic disease, in which plaque buildup narrows the brain arteries, is one of the most common causes of strokes.

Neurosurgeons performing EDAS reroute arteries from the scalp and the membranes that cover the brain and place these arteries under the skull near areas of the brain at risk of stroke. Over time, new blood vessels form, creating fresh pathways for blood and oxygen to reach the brain.

The trial, led by Nestor R. Gonzalez, MD, professor of Neurosurgery and director of the Neurovascular Laboratory at Cedars-Sinai, enrolled 52 patients with severe brain atherosclerosis, also known as intracranial atherosclerotic disease, or ICAD, who showed symptoms of either a recent stroke or a mini-stroke, called a transient ischemic attack. These patients received EDAS surgery, along with intensive medical management, which included diet and lifestyle changes, blood thinners and other medications to control blood pressure, cholesterol and blood sugar levels. 

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