Prompt use of a small stent to retrieve a stroke-causing blood clot is safe and helps most patients who suffer a severe stroke recover faster and better.
This was the conclusion of a study published in the New England Journal of Medicine that involved over a dozen Dutch hospitals and a large team of researchers, including members from the Erasmus University Medical Center in Rotterdam.
Most patients who underwent the procedure had less brain damage, fewer neurological problems and were better able to care for themselves, the study finds.
According to the Centers for Disease Control and Prevention (CDC), stroke is the fourth leading cause of death among Americans and a major cause of adult disability.
Around 800,000 people a year suffer a stroke in the US, and one American dies every 4 minutes from the cardiovascular event.
There are two main types of stroke: ischemic - by far the most common and the subject of the new study - and hemorrhagic. Ischemic stroke is where a blockage in a blood vessel stops blood getting to one or more parts of the brain. Hemorrhagic stroke is where a weakened blood vessel in the brain ruptures.
After a stroke, patients can be left with severe problems including speech and language impediments and paralysis. If they do not receive prompt treatment, about half of patients who suffer acute ischemic stroke become severely disabled.
Current practice of giving clot-busters only helps 1 in 10 stroke patients
It is currently standard practice for patients suffering acute ischemic stroke (AIS) to receive clot-busting drugs intravenously, but this usually only works for 1 in 10 patients.
For the study, the team enrolled 500 patients with AIS and randomly assigned 233 to intra-arterial treatment (190 involving the stent procedure) and 267 to standard care. The average age of the patients was 65, and nearly 90% of them received the clot-busting drug alteplase before treatment began within 6 hours of symptom onset.
The blood-clot retrieval procedure involves inserting a catheter through an opening in the groin into a blood vessel and gradually advancing it until it reaches an artery in the neck.
Then, a thin catheter is navigated to the blocked artery in the brain. Through this, a small stent - a tube made of wire mesh - is pushed forward and expanded to capture the clot. The stent is then withdrawn - holding the captured clot - and removed through the catheter.
Patients who had the stent procedure recovered better and had less brain damage
The study results showed that the patients who had the stent treatment recovered better than the patients who did not. For example, they had less difficulty walking, dressing, taking care of themselves and going about their daily activities.
Brain scans also revealed that the patients who had the stent treatment had less brain damage.
The authors note also that there "were no significant differences in mortality or the occurrence of symptomatic intracerebral hemorrhage," between the two groups of patients.
The study concludes that when given within the first 6 hours of stroke symptoms onset, the stent procedure to remove the clot is safe and effective.
Lead investigator Diederik Dippel, professor of neurology at Erasmus University Medical Center, says:
"This study can have a major impact on the treatment of patients with an AIS. Many patients would be eligible for this new treatment method, potentially sparing a large number of patients from a life with serious disabilities."