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New study reveals importance of removing blood clots after stroke


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2/11/2015
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A new study shows that some patients might not be getting the best treatment possible after a stroke.

Fox news reports on the best course of treatment for stroke patients.

Researchers are emphasizing the importance of removing blood clots after strokes as they often block blood flow to a patient’s brain.

What do doctors normally do to treat stroke patients?

Most doctors simply give their patients clot busting drugs, but experts say this is not good enough. They say it is important that doctors physically remove the clot. Experts are saying this will drastically improve a patient’s chances of making a full recovery.

Two studies showed this same information on stroke treatment.

“The larger of the studies found that the procedure nearly halved the death rate from stroke. The two studies used devices made by Covidien, which was acquired by Medtronic PLC last month and helped pay for one of the trials. Stryker Corp and privately held Penumbra Inc. also manufacture devices approved for clot removal. The research echoes a large Dutch study published in December, called MR CLEAN, that also found a benefit from fishing a clot out of an artery,” according to Fox news.

Dr. Lyden, director of the Stroke Program at Cedars-Sinai Medical Center in Los Angeles, who was not involved in the studies, has done extensive research on these topics. He told Fox that these studies are on to something important. Dr. Lyden, helped develop clot-busting drugs, and said he had been skeptical of the devices, but called the latest results of these studies ‘tremendous’. He also said this is a whole new world for doctors. Dr. Lyden said medical centers are going to have to gear up and be able to do this treatment as soon as possible.

The two studies were credited and reported at the American Heart Association/American Stroke Association International Stroke Conference and it was also released in summary form by the New England Journal of Medicine. The studies led trial runs to test their theories.

“In one trial, called ESCAPE and conducted at 22 centers worldwide, 53 percent of 120 patients who had clot removal via a tube fed into a blood vessel of the brain were functionally independent 90 days later. Of the 118 who received only the standard clot-busting drug, 29 percent were. While 19 percent of patients receiving drugs alone died within three months, only 10.4 percent of those whose clots were removed died. The second study, called EXTEND-IA and based in Australia, found that 24 hours after treatment all of the oxygen-starved brain tissue in 35 patients whose clot was removed was getting blood again. That compared to 37 percent of the tissue in patients receiving only the clot-busting drug alteplase,” according to Fox.

What were the final results?

After around 90 days the authors found that 71 percent of the clot-removal group had achieved functional independence. Researchers compared this to those given conventional care where only 40 percent came to the point of functional independence. Both of these trial runs were halted early because the advantages of extracting the clot were so particular.

Dr. Hill from Calgary University explained the importance of collateral circulation. There must be blood flow bypassing the clot because the brain dies very quickly, it can happen as quickly as within fifteen minutes.



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