After three decades of failure, researchers have found a treatment that greatly improves the prognosis for people having the most severe and disabling strokes.
By directly removing large blood clots blocking blood vessels in the brain, it’s possible to save brain tissue that otherwise would have died, enabling many to return to an independent life.
According to a Columbus Dispatch report, the study conducted in the Netherlands, is being met with excitement.
Doctors used a new type of snare to grab the clots. It is a stent, basically a small wire cage, on the end of a catheter that is inserted in the groin and threaded through an artery to the brain. When the tip of the catheter reaches the clot, the stent is opened and pushed into the clot. It snags the clot, allowing the doctor to withdraw the catheter and pull out the stent with the clot attached.
"This is a game changer," said Dr Ralph L Sacco, chair of neurology at the University of Miami’s Miller School of Medicine.
"A sea change," said Dr Joseph Broderick, director of the neuroscience institute at the University of Cincinnati. People with smaller clots are helped by the lifesaving drug tPA, which dissolves them. But for those with big clots, tPA often does not help. Until now, no other treatments had been shown to work.
The new study involved 500 stroke patients – 90% got tPA and half were randomly assigned to get a second treatment, as well. A doctor would try to directly remove the clot from the patient’s brain. The study did not specify how the removal would happen. There are several methods, but the vast majority were treated with the new stent.
One in 5 patients who had tPA alone recovered enough to return to living independently. But 1 in 3 who also had their clot removed were able to take care of themselves after their stroke.
[link url="http://www.dispatch.com/content/stories/national_world/2014/12/17/treatment-helps-those-with-worst-strokes.html"]Full Columbus Dispatch report[/link]
[link url="http://www.nejm.org/doi/full/10.1056/NEJMe1413346"]The New England Journal of Medicine article summary[/link]