A study presented at the
European Stroke Organization conference in Prague showed that treatment for
severe-stroke patients as late as 24 hours after a stroke can restore brain
function.
The study employed a clot-retrieval device
from Stryker Corp and was conducted on
206 patients with serious strokes at 32 hospitals in the U.S., Spain, France
and Australia.
The researchers suggested that 40% of patients
with severe stroke fit in this new window of opportunity. They were able to
lower by 73% the risk that a patient would become dependent on another person or
health care providers for help in their daily activities.
For the past two decades, the clot
dissolving drug tPA was the primary treatment for ischemic stroke. But the drug
was useful only until about 4 ½ hours after a stroke. Clot-retrieval devices
widened that window to about 6 hours, but brain tissue was considered
irreparably damaged after that.
As the results of this study are promising a larger trial should be conducted as initiating treatment in the first 6 hours after ictus is difficult even in the most well organized centers. As clot retrievers are used approximately in 25,000 cases in the U.S. every year the issue of the length of opportunity to intervene should be settled. Another
issue that should be looked at is the role an intact and complete circle of
Willis plays on how patients respond to treatment.
