ST. LOUIS – A “retrievable stent” used by stroke experts at Saint Louis University Hospital that physically removes clots from the brain, has shown great benefit in treating patients with large strokes, according to new research.
The technique is similar to how cardiologists open up arteries after a heart attack. By inserting a catheter into an artery in the leg, specialists run the stent through the body into the brain where a clot is lodged. Once there, the clot is trapped in the stent and pulled out of the brain, restoring blood flow.
“The goal is to improve the outcome in patients who otherwise would have deadly or disabling strokes,” says Randall Edgell, MD, interventional neurologist at Saint Louis University Hospital and a SLUCare physician.
Historically the treatment for stroke has been the drug tPA. Given within a three-hour window of a stroke, tPA is designed to dissolve the clot. While it’s very effective in patients with smaller clots, for large strokes with larger clots, there are times where more is needed. That’s where this stent may come into play.
A study in the December 17, 2014 New England Journal of Medicine found using stents greatly lowered the risk of disability in patients whose clots were not dissolved by tPA. Three new studies presented at the American Stroke Association conference in February 2015 added to that finding. The studies were so successful, they were all stopped early because independent monitors saw better results in those treated with stents after tPA failed to dissolve clots.
“I think this is going to be a transformative moment in how we treat stroke,” says Dr. Edgell, who has used the stent for several years at SLU Hospital. “Now we have two very powerful treatments that can halt – and in some cases reverse – stroke symptoms and I think that will motivate people to get medical attention more often and more quickly.”
Overall, the message Dr. Edgell and all stroke experts want for the public, is to recognize stroke symptoms by the acronym FAST. Facial drooping, arm weakening, speech difficulty, and time to call 911.
“Most of the time when we are not able to offer this treatment or tPA it’s because patients have waited too long, hoping symptoms would improve on their own, and what the best strategy would be is to take no chances and come directly to the emergency room,” says Dr. Edgell.
He says the technology should be useful as well for members of the MidAmercia Stroke Network, founded by SLU Hospital in 2008 to help build collaboration among hospitals and help stroke patients throughout the region.
For more information about stroke, visit midamericastrokenetwork.com.