Promising New Stroke Treatment Shows Dramatic Improvement in Stroke Symptoms
The majority of strokes occur because a clot restricts the flow of blood to an area of the brain, causing it to die. Persons who survive a severe stroke can linger for a decade or more with devastating physical and mental impairments. Strokes kill approximately 163,000 Americans annually and are a leading cause of long-term disability.
The costs of their care can quickly drain a family’s financial resources. Recognizing the symptoms of a stroke and getting appropriate treatment rapidly can determine the severity of the outcome. New treatments are offering hope for a full recovery within days or months.
In the past decade, the clot-buster TPA has been administered to dissolve brain clots. Originally used for heart attacks, TPA was shown to be also effective for strokes if given intravenously during the first three hours after onset of symptoms. It doesn’t always work for the patient and sometimes causes bleeding in the brain.
In 2005, a new stroke treatment – a corkscrew device to physically remove the clot – came into use for certain patients with major strokes. Now, an experimental treatment gives doctors even more options to help save lives and minimize the disabilities that strokes can produce.
Doctors involved in clinical studies are now delivering TPA precisely to the clot area and dripping the dissolving agent directly onto the blockage. Similar to angioplasty, in which a catheter is threaded through a vessel in the groin to the heart blockage, a tube is guided to the brain instead. TPA is delivered through a specialized tube to the clot, instead of making its way there through the bloodstream.
Many patients given this experimental treatment made stunning recoveries by the next day – often without the speech loss and paralysis that can result from stroke. One study found that after this novel treatment, 65 percent of patients were able to walk, talk and function normally after three months, compared to those given standard care.
According to study leader Dr. Doojin Kim, one-fourth of 128 patients given this localized treatment at UCLA over ten years at UCLA showed dramatic improvement of stroke symptoms within a day of administering TPA with the drip method.
Ninety percent of them survived, compared with 74 percent of stroke patients receiving standard intravenous TPA. Not only did they survive, they had excellent final outcome. Bleeding in the brain was less common with the new approach.
In a second study, 73 patients with severe strokes first got intravenous TPA, followed by the dripped treatment if needed. Some also received ultrasound through the TPA tube to further break up the clot. Bleeding was a more common side effect, but the twice as many clots were dissolved.
The new dripping technique is suggested for patients under age 80 who suffer a major stroke. Using those criteria, doctors estimated that up to half of stroke patients might qualify for the procedure. Only about 30 percent of clots dissolve with intravenous TPA alone, according to Dr. Gergory Del Zoppo, a stroke expert from Scripps Research Institute in La Jolla, CA.
Now physicians must decide which individuals would do best with various clot-dissolving strategies instead of using the corkscrew type device to pull out the clot.
Both the dripping technique and the corkscrew device promise to give stroke patients another option if their initial treatment with intravenous TPA fails. Doctors involved with the new treatment strategies agree that relative risks and benefits of each need further study.
The costs of their care can quickly drain a family’s financial resources. Recognizing the symptoms of a stroke and getting appropriate treatment rapidly can determine the severity of the outcome. New treatments are offering hope for a full recovery within days or months.
In the past decade, the clot-buster TPA has been administered to dissolve brain clots. Originally used for heart attacks, TPA was shown to be also effective for strokes if given intravenously during the first three hours after onset of symptoms. It doesn’t always work for the patient and sometimes causes bleeding in the brain.
In 2005, a new stroke treatment – a corkscrew device to physically remove the clot – came into use for certain patients with major strokes. Now, an experimental treatment gives doctors even more options to help save lives and minimize the disabilities that strokes can produce.
Doctors involved in clinical studies are now delivering TPA precisely to the clot area and dripping the dissolving agent directly onto the blockage. Similar to angioplasty, in which a catheter is threaded through a vessel in the groin to the heart blockage, a tube is guided to the brain instead. TPA is delivered through a specialized tube to the clot, instead of making its way there through the bloodstream.
Many patients given this experimental treatment made stunning recoveries by the next day – often without the speech loss and paralysis that can result from stroke. One study found that after this novel treatment, 65 percent of patients were able to walk, talk and function normally after three months, compared to those given standard care.
According to study leader Dr. Doojin Kim, one-fourth of 128 patients given this localized treatment at UCLA over ten years at UCLA showed dramatic improvement of stroke symptoms within a day of administering TPA with the drip method.
Ninety percent of them survived, compared with 74 percent of stroke patients receiving standard intravenous TPA. Not only did they survive, they had excellent final outcome. Bleeding in the brain was less common with the new approach.
In a second study, 73 patients with severe strokes first got intravenous TPA, followed by the dripped treatment if needed. Some also received ultrasound through the TPA tube to further break up the clot. Bleeding was a more common side effect, but the twice as many clots were dissolved.
The new dripping technique is suggested for patients under age 80 who suffer a major stroke. Using those criteria, doctors estimated that up to half of stroke patients might qualify for the procedure. Only about 30 percent of clots dissolve with intravenous TPA alone, according to Dr. Gergory Del Zoppo, a stroke expert from Scripps Research Institute in La Jolla, CA.
Now physicians must decide which individuals would do best with various clot-dissolving strategies instead of using the corkscrew type device to pull out the clot.
Both the dripping technique and the corkscrew device promise to give stroke patients another option if their initial treatment with intravenous TPA fails. Doctors involved with the new treatment strategies agree that relative risks and benefits of each need further study.
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