Saturday, April 18, 2015

New clot-removal attack better than drugs alone for stroke patients

A new study has found that the removal of the clot causing a severe stroke plus standard medication yields better long term outcomes in stroke patients than drug alone.

Co-author Demetrius Lopes from Rush University Medical Centre said that these findings are a game-changer for how they should treat certain types of stroke adding that these outcomes are the difference between patients being able to care for themselves after stroke and being dependent.

During a minimally invasive procedure called thrombectomy to remove the clot, a neurovascular surgeon threads a catheter through an incision in the patient's groin, snaking it through the blood vessels and into the brain. The doctor then uses a device attached to the catheter to grab and dislodge the clot and pull it all the way out through the incision, a bit like an angler reeling in a fish. The study found that the patients who received intravenous tissue plasminogen activator (IV tPA) plus thrombectomy exhibited reduced disability across the entire range of the measurement, with a functional independence rate of 60% compared to 35.5% for those patients who received only IVtPA.

For every 2.6 patients treated, one additional patient had an improved disability outcome; for every four patients treated, one additional patient was independent at 90 day follow-up, the article declared. The study also found that patients who received thrombectomy had better cerebral blood flow rates: At 27 hours after treatment, 82.8% of those patients had blood flow that was 90% of normal or better, versus 40.4% of patients who only received IV tPA.

The study appears online in the New England Journal of Medicine.

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