A new procedure that captures blood clots blocking large arteries in the brain dramatically improved outcomes for stroke patients and may now set a new standard in treatment, according to an article recently published in the New England Journal of Medicine.
Researchers have completed an international, randomized controlled trial showing that the clot-retrieval procedure, known as endovascular stroke rescue therapy (ESRT), can dramatically improve patient outcomes after an acute ischemic stroke, according to the study. Three other similar trials will be reporting their findings soon.
Crouse Hospital endovascular neurosurgeon Eric M. Deshaies, MD, FAANS, FACS, was a primary investigator in an international stroke rescue trial looking at the use of stent retrieval devices for ESRT.
The recent announcement affirms that this method is safe and effective in removing clots in the brain’s largest blood vessels – the carotid, anterior and middle cerebral arteries – which are linked to the most serious disabilities after a stroke. Evidence released at the International Stroke Conference held recently in Nashville supports its use in more stroke cases, with researchers saying that the technique has dramatically improved patients’ ability to function.
Designed to reduce the severity of a stroke and limit potential disability afterward, the procedure uses a retrievable stent and catheter device to restore blood flow and retrieve clots from blocked blood vessels in patients experiencing acute ischemic stroke.
A micro-sized stent is delivered through a micro-catheter, which is put into a groin blood vessel and guided with X-rays upward through the body, through the neck area and into the larger blood vessels of the brain, where the clot has been detected. The stent is opened up – similar to how a heart catheterization procedure works – and it captures the clot, removing pieces of it through the catheter, which immediately restores blood flow to that area of the brain.
Dr. Deshaies was the second endovascular neurosurgeon in New York State to perform a blood clot retrieval procedure on a stroke patient when the device first became available in 2013. “I knew immediately that this device would be a game-changer in the way we manage stroke patients. Now we have the data that proves this to be true,” says Dr. Deshaies, one of only a few dual fellowship-trained neurosurgeons in the country and the only one in Central New York.
Ischemic stroke is caused by a sudden blockage of an artery to the brain that deprives the brain of critical nutrients, such as glucose and oxygen. Currently, the standard of care is to administer a “clot buster” drug called tPA to attempt to dissolve the blood clot. Overall, positive outcomes for patients increased from 19 percent to 32 percent. In many cases, instead of suffering major neurological disability, patients went home to resume their lives.