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This Revolutionary Stroke Treatment Will Save Millions of Lives. Eventually

The challenge is that this medical innovation isn’t as deployable as a new pill or device. It can’t be manufactured by the thousands, packed into shipping containers and distributed to every hospital whose administrator clicks Add to Cart. For a qualified specialist, the extraction of the clot itself can be fairly straightforward — but getting the patient to the table in time is a highly complex process, a series of steps requiring layers of training and a rethinking of the protocols that move people around within the medical system. The new “miracle treatment” is the easy part. Bringing it to the people who need it, around the world? Achieving that will be miraculous.

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Featured

  A Revolution in Fighting Clots

A technique called thrombectomy widens the time window in which stroke victims can be treated.

Articles of Interest

The pharma industry has failed stroke, so doctors are looking elsewhere

The cutting-edge treatment for stroke isn’t an elegantly crafted drug or a gene therapy, but a device that works like a pipe cleaner. It’s a thin metal catheter that snakes its way up from a patient’s thigh, through their heart, and into the blood vessels of the brain, where it clears the obstruction causing the stroke. The technology, called “mechanical thrombectomy” or “endovascular therapy,” has become the preferred treatment for certain set of ischemic strokes not because it’s easy or inexpensive—it is neither of those things—but because the pharmaceutical industry has largely failed to develop a drug that works as well.

Vacuum cleaner for the brain: doctor’s first-hand account of using groundbreaking stroke treatment

Thrombectomy is a revolutionary stroke treatment where the offending clot is literally sucked out of the patient’s brain. I performed my first thrombectomy in 2006, but I remember it as though it was yesterday.

A Lazarus Patient And The Limits Of A Lifesaving Stroke Procedure

In 2015, after several studies demonstrated how effective mechanical thrombectomy is for certain stroke patients, the American Heart Association/American Stroke Association issued new guidelines making it part of their recommended standard medical care. But not all patients who could benefit from the procedure are getting it, says Guillermo Linares, director of neuro-interventional services at Temple University Hospital. The biggest issue is timing.

Clot-Grabbing Devices Offer Better Stroke Outcomes

Long-term follow-up of patients in a 2014 study confirms that stroke patients recover better if doctors physically remove a clot from a blocked artery instead of just letting the clot-busting drug tPA try to do the job.

European WAKE-UP Trial Shows Benefit Of Thrombolysis In Stroke With Unknown Time Of Onset

The positive result of WAKE-UP is a milestone towards further improvement of the treatment of acute stroke, as the trial opens the window for treating a large number of patients that have been excluded from thrombolysis until now.”, says Prof. Thomalla. „Treatment based on MRI-selection without knowing the time of symptom onset represents a paradigm change for acute stroke thrombolysis..“

Monumental Change in Stroke Treatment: Combining the Old With the New

“The mantra in stroke treatment is that ‘Time is brain,’ so we needed a more efficient and effective standard of care,” Dr. Fitzsimmons said. While IV tPA alone may take hours to dissolve a blood clot, thrombectomy can remove a clot in a matter of minutes. “This is the most significant development in stroke therapy in twenty years,” Dr. Fitzsimmons said. “Technology has advanced to the point where we now have thrombectomy devices to help patients that are far superior to anything from the past.

Primary and Comprehensive Stroke Centers: History, Value and Certification Criteria

Stroke has transitioned from a disease dominated by neurologic consultation services only to one managed by vascular neurologists in geographical stroke units, stroke teams and care pathways, primary stroke center certification according to The Joint Commission, and most recently comprehensive stroke center designation under the aegis of The Joint Commission.

So You Can Use a Clot Retriever? Great, but Not Enough

Stroke needs to go the way of trauma care to protocolize endovascular thrombectomy, one expert says.

Stroke Study Sparks Call for Revamping Emergency Care Plan

To some experts, the study is a call to rejigger the current method of determining where ambulances ought to take stroke patients, which is based solely on proximity. Instead, they say, patients with apparent severe strokes should be rushed to hospitals that perform thrombectomies.

Triple Win for Clot Retriever Devices in Acute Stroke

Early endovascular clot removal improved stroke outcomes over medical treatment with thrombolytics alone, three trials showed here in what was seen as major verification that would change practice.

Why the Go-To Stroke Drug Can Fail

The go-to stroke drug often fails. Now doctors can slide out brain clots with wires and have new tools for other blockages

Resources

Rebel EM

Approximately 80% of strokes are ischemic in origin leading to significant morbidity and mortality worldwide. In ischemic stroke, there is usually a core infarct and an ischemic penumbra. There have been many studies evaluating endovascular therapy in the management of ischemic stroke published in the past few years. This post will serve as a review of those studies.