New procedure a major breakthrough in stroke treatment: Canadian study

Posted: Published on February 13th, 2015

This post was added by Dr Simmons

A new stroke treatment has been shown to be so effective that Canadian researchers say they believe it will be used as part of standard stroke care.

The results of a new study, led by scientists at the University of Calgarys Hotchkiss Brain Institute and published online Wednesday in the New England Journal of Medicine, found a clot-retrieval procedure, called endovascular treatment, significantly decreased the incidence of disability or death among those who experienced acute ischemic stroke.

The treatment, which involves removing blood clots in the brain with a retrievable stent, also nearly doubled the percentage of patients who experienced positive outcomes from 30 per cent to 55 per cent.

Thats a massive jump [in] people going home, people going back to work, people being independent, people not having to live in nursing homes, says the studys co-principal investigator Dr. Mayank Goyal, a professor of radiology and clinical neurosciences at the University of Calgarys Cumming School of Medicine. Its a major, major breakthrough in the disease.

Dr. Rick Swartz, a study collaborator, medical director of the stroke program at Sunnybrook Health Sciences Centre and an acting spokesman for The Heart and Stroke Foundation, says he thinks Canada will be one of the first countries in the world to incorporate this treatment into our best practice guidelines.

Best practices for stroke care are developed by stroke experts across the country with funding from the foundation, which was one of the sponsors of the study.

The Canadian sites involved in the study, which already have the equipment and expertise, can begin using the procedure immediately, Dr. Goyal says.

In severe cases of ischemic stroke, blood clots block larger arteries at the base of the brain. Until now, the standard treatment has been to give patients a clot buster drug, known as tPA or tissue plasminogen activator, which dissolves clots and restores blood flow. For larger clots, this can be time-consuming and in stroke care, time is brain. For every minute the brain is starved of fresh oxygenated blood, its believed about two million neurons die.

Though endovascular treatments have been evolving for two decades, the latest generation of stent retrievers are game-changers. Medical teams involved in the study conducted at 11 sites across Canada and another 11 around the world, including the United States, Britain, Ireland and South Korea were able to identify the blood clots and their location in the brain using advanced imaging, and then quickly extract them using stent retrievers, in some cases, within minutes.

The Canadian study, which involved 316 patients, is the first to show a decline in patient mortality: to one in 10 patients, compared with two in 10 patients when current standard treatment was used alone.

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New procedure a major breakthrough in stroke treatment: Canadian study

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