"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 trial presented today at the World Stroke Congress in Montreal. Atherosclerotic disease in which plaque buildup narrows the brain arteries is one of the most common causes of strokes https  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 httpbio.csmc.eduviewNestorGonzalez.aspx professor of Neurosurgery and director of the Neurovascular Laboratory at CedarsSinai enrolled  patients with severe brain atherosclerosis also known as intracranial atherosclerotic disease or ICAD who showed symptoms of either a recent stroke or a ministroke called a transient ischemic attack https 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. After one year . percent of the patients treated with the surgery experienced another ischemic stroke or died compared with . percent of patients in a matched control group who received only intensive medical management. Two of the EDAS patients had small wound openings that required additional surgical interventions but there were no intracranial hemorrhages or other serious adverse events the researchers reported. Our findings in this intermediatestage trial are promising for applying EDAS surgery to intracranial atherosclerotic disease said Gonzalez said. Previously EDAS has been used for moyamoya disease a rare cerebrovascular disorder that affects younger patients.  Gonzalez said the new trial addressed a serious medical need. Even under the best current treatments ICAD carries high rates of recurrent stroke and death compared with other causes of stroke he said. Developing new therapeutic strategies is crucial for ICAD patients. Current ICAD therapiesin addition to intensive medical managementinclude bypass surgery to connect a blood vessel from outside the brain to a vessel inside the brain as well as angioplasty with stenting which involves inflating a tiny balloon inside a cerebral artery to open it up and placing a stent device inside the artery. Despite advances in medical care annual rates of recurrent stroke and death are remain high at  percent or more for ICAD patients according to published research. Gonzalez said his team is working with the stroke prevention working group of the National Institutes of Health to develop a proposal for a Phase III randomized clinical trial across multiple institutions to further test the effectiveness of EDAS as compared with intensive medical management. While this Phase IIa trial selected patients from previous studies as the control group the Phase III study would enroll new ICAD patients for both the control and experimental groups he explained. This clinical trial moves us significantly closer to preventing strokes and death in highrisk populations said Keith Black MD httpbio.csmc.eduviewblack.aspx professor and chair of the Department of Neurosurgery. As a nationally renowned physicianinvestigator Dr. Gonzalez personifies the dedication of CedarsSinai to translating the most advanced research into new cures.   Besides Gonzalez the trial involved other investigators from the stroke centers https of CedarsSinai and UCLA.  Funding Research reported in this publication was supported by the National Institutes of Neurological Disorders and Strokes of the National Institutes of Health under award number KNSA."