New stroke therapy apparently breakthrough

In new therapy, blood clots are removed with a wire

02/13/2015

In the future, doctors could go new ways in the treatment of strokes. While the standard method of dissolving the blood clot (lysis therapy) has so far been successful, it is more promising to extract the blood clot using catheters in the brain. So the result of three recent investigations, two of which on Wednesday evening received a lot of attention at the „International Stroke Conference“ (ISC) in Nashville, Tennessee. The patients treated with the new method were less likely to have severe disabilities due to stroke. The death rate was also halved in one study.

Blood clots are pulled out of the brain during a stroke using a catheter
The so-called stent thrombectomy has been carried out in large neurological clinics for many years. So it is successfully used in heart attack to open the closed blood vessel. The procedure could also prevail in the treatment of strokes. The promising results of three studies put the physicians at the ISC in great euphoria. So was among others from the „Breakthrough in stroke therapy“ spoken.

In stent thrombectomy, a catheter is pushed from the groin through the large body artery into the brain, where the wire pulls back the blood clot that blocks the cerebral artery. „It is not uncommon for the stroke patient to start talking or moving the hand on the catheter table afterwards, "quotes „Mirror online“ Timo Krings, Professor of Neuroradiology at the University of Toronto, who was involved in one of the studies. „Finally, you have something against the stroke in your hand that works. "

The studies, one in Canada and the other in Australia, together with a Dutch study, could revolutionize stroke therapy. „The results are so overwhelmingly positive that you can not close your eyes to it, "says Krings.

Lysis therapy with stent thrombectomy was most successful in stroke patients
In the studies, patients were randomly divided into two groups. One group of patients was treated with the current standard procedure, the lysis therapy, the other group received a stent thrombectomy in addition to the drug therapy in which the blood clot is to be dissolved. The result was clear in all three studies: the lysis therapy in combination with the new procedure performed significantly better than the lysis therapy alone.

„55 percent of the patients who received stent thrombectomy in the study went home without significant disability, "said co-research director Dr. Mayank Goyal, professor of radiology and clinical neuroscience at the Cumming School of Medicine „CTV News“ with regard to the results of the Canadian study. „This compared to patients who did not receive stent thrombectomy in the study. Of these, only 30 percent were dismissed without disability.“

In one of the studies, mortality was halved thanks to the new method. Out of an average of two deaths among ten stroke patients, there was only one more with stent thrombectomy.

Stent thrombectomy could become the standard procedure in stroke
Although the lysis therapy has significant benefits for the patient, it is always associated with the risk of unwanted bleeding. In addition, those affected must be treated no later than three hours after the stroke. Therefore, doctors have been looking for an improved procedure for years. With stent thrombectomy such a method could have been developed.

„This is the most important and fundamental change in the treatment of acute ischemic stroke in the last 20 years“, cited „CTV News“ the senior author of the Canadian study, dr. Michael Hill from the Cumming School of Medicine.

Experts now expect a serious discussion on how and when stent thrombectomy will be introduced as the standard treatment for stroke in Germany. But this requires large-scale changes. „A normal stroke unit is no longer sufficient for this type of treatment, "says Krings, neurology professor Jan Sobesky from the Center for Stroke Research at the Berlin Charité „Mirror online“, that one needs neurovascular centers with a direct link to neuroradiology, „where specialists are also available at two o'clock in the morning, where high-level imaging can be done around the clock, where there is a neurological intensive care unit and neurosurgery. "Sobesky is also impressed by the study results: „These are impressive results. Now there is a spirit of optimism.“