A short treatment window expands.
For people who suffer a stroke, successful treatment is a race against time. “The sooner you get treatment, the better the
Yet while stroke remains a leading cause of death and disability, recent advances in treatment for the most common type of stroke have given doctors and patients new hope.
New Approach
The type of treatment a stroke patient gets depends on the type of stroke that has occurred. The most common kind, ischemic strokes, are triggered by a blocked artery, usually caused by a blood clot. Physicians can use a protein known as tissue plasminogen activator (tPA) to dissolve the clot. “This treatment can be very effective, but only within the first few hours of a patient having an acute ischemic stroke,” Dr. Kung says.
Over the last decade, a new endovascular approach has lengthened the treatment time window for ischemic strokes. It involves physically removing the clot through a technique called thrombectomy, in which a physician guides a catheter through the femoral (thigh) or radial (wrist) artery and up into the brain using X-ray guidance.
“Once we find the blood clot, we can either use suction to remove it or use mesh to retrieve it and pull it out of the vessel,” Dr. Kung says. Vascular neurosurgeons at SBMC may perform thrombectomy using local or general anesthesia, depending on the patient’s condition. Thrombectomy can be effective for six to 24 hours after a stroke has occurred. “However, it is important to know that the sooner the blood flow is restored, the better the outcome,” says Dr. Kung.
Dramatic Results
Numerous studies published over the past seven years show thrombectomy’s benefits. A multisite clinical trial, published in The New England Journal of Medicine, compared 92 patients who received thrombectomy to 90 patients who received medical therapy alone.
After three months, fewer patients receiving thrombectomy died (14 percent) compared to those receiving medical treatment alone (26 percent). In addition, 45 percent of patients receiving thrombectomy achieved functional independence compared to 17 percent of patients in the control group.
“These results are dramatic,” Dr. Kung says. “It’s very rare in medicine to have data that overwhelmingly shows how a procedure is safe, effective and improves quality of life in every way you can measure it.”
Speed is still of the essence when it comes to stroke treatment. “Don’t wait to get help,” Dr. Kung says. “Call 911 as soon as you see the first signs of stroke.”
Saint Barnabas Medical Center is home to a state-designated Comprehensive Stroke Center and Joint Commission-certified Advanced Primary Stroke Center. To learn more, call 973-322-6500.