“We think P.E.T. scans can more accurately determine which patients are more likely to benefit from surgery.”

—Patrick Hitchon, M.D.

Neuroscientists evaluate whether P.E.T. scans and brain surgery help stroke patients avoid a recurrence

Can brain bypass surgery prevent people from having a second stroke?

To answer that question, neuroscientists at University of Iowa Hospitals and Clinics are participating in a five-year, multi-center, National Institutes of Health-funded study comparing brain bypass surgery with medication therapy.

Stroke or a milder form of stroke called transient ischemic attack (TIA) occurs when the carotid artery—one of the main blood vessels supplying the brain with blood—becomes blocked. Despite pharmaceutical advances, these patients face a 25 percent risk for having another stroke within two years.

 “We want to find out if brain bypass surgery can improve that situation for these patients,” says UI neurologist Patricia Davis, M.D.

Brain bypass surgery developed in the 1970s used a vessel from the scalp to carry blood to the brain. Earlier studies did not use sophisticated testing to identify appropriate patients for bypass and did not show a clear-cut permanent benefit to the procedure.

A newer technology called positron emission tomography (P.E.T.) might overcome this shortcoming. P.E.T. generates images that reflect blood flow and the consumption of oxygen on the side of the occlusion,  therebymay helping predict who might benefit from brain bypass surgery and who might not.

Studies have shown that patients with impaired circulation to the brain as seen on P.E.T. are five to 10 times more likely to suffer a stroke than patients without a significant blood flow on the side of the blocked artery. This study proposes to treat patients with a blocked carotid artery with either the best medical treatment or a bypass operation to see if the bypass reduces the risk of stroke more than medicine.

For more information, patients and families may call UI Health Access and ask for Pamela Jacobs, R.N., call her directly at 319-384-5824, or send e-mail to pamela-jacobs@uiowa.edu. To be seen in the neurosurgery clinic, patients will need a physician referral. Patients will not need a referral to be seen in the neurology clinic.

For consultation or referral, physicians should call UI Consult.