New Method to Reduce Stroke Disabilities

New Method to Reduce Stroke DisabilitiesNew Method to Reduce Stroke Disabilities

A group of scientists at the American Heart Association led by Iranian researcher Arash Khalessi have compiled and published an updated set of guidelines for emergency treatment of patients with acute ischemic stroke following the results of five random clinical trials of endovascular treatment last year.

The new guidelines recommend endovascular treatment using small mechanical devices known as stent retrievers that allow removal of large clots from a blocked artery in the brain and add mechanical thrombectomy to the treatment regimen, reports IRNA.

“The efficiency of endovascular therapy with these devices used in numerous ischemic stroke patients around the world, helped us achieve the results,” said Dileep R. Yavagal, associate professor of neurology and neurological surgery, who is also on the elite panel and director of Interventional Neurology at UHealth – University of Miami Health System.

Stroke is the fifth cause of death and the single leading cause of serious disability in Iran.

These guidelines usher in a revolutionary change in the treatment of stroke nearly 20 years after the intravenous clot-busting medication tPA (tissue plasminogen activator) were first approved; the treatment will vastly improve the chances of patients with disabling strokes and is recommended with the highest level of scientific certainty, Yavagal said.

A clot-busting drug, tPA must be given intravenously within 4.5 hours to be effective and has long been the standard treatment.

However, tPA does not always dissolve blood clots in large arteries.

In this type of stroke, endovascular therapy, similar to those used for heart attacks, is better in restoring blood flow in the brain.

Five studies, all published in the New England Journal of Medicine in the past six months, demonstrated that this new treatment benefits stroke patients.

Yavagal led the group at University of Miami’s Jackson Memorial Hospital in one of the studies, which examined the use of Solitaire, a stent-retrieval device made by Medtronic.

He was also on the data safety monitoring board of another study, ESCAPE, in the same group of studies.

“The trials clearly showed that mechanical thrombectomy can reduce long-term disability in thousands of patients,” said Ralph L. Sacco, Professor and Chairman of Neurology, Olemberg Family Chair in Neurological Disorders and President-elect of the American Academy of Neurology.

 “By publishing the guidelines, we are able to expand this revolutionary approach to larger numbers of stroke patients and improve their outcomes,” said Yavagal.