But there is nothing proven here that these stents are placed fast enough to stop the neuronal cascade of death. More proof that our stroke professionals do not know what f*ckingly hard problems in stroke to tackle.
http://www.news-medical.net/news/20150703/New-AHAASA-guidelines-recommend-stent-retrievers-to-treat-strokes-in-selected-patients.aspx
New devices called stent retrievers are enabling physicians to
benefit selected patients who suffer strokes caused by blood clots. The
devices effectively stop strokes in their tracks.
For the first time, new guidelines from the American Heart
Association/American Stroke Association recommend the treatment for
carefully selected patients who are undergoing acute ischemic strokes
and who meet certain other conditions.
Loyola University Medical Center stroke specialist Jose Biller, MD,
is a member of the expert panel that wrote the guidelines, published in
the journal Stroke. Dr. Biller is chair of the Department of
Neurology of Loyola University Chicago Stritch School of Medicine. Lead
author is William Powers, MD, neurology chair at the University of North
Carolina at Chapel Hill.
About 85 percent of strokes are ischemic, meaning they are caused by
clots that block blood flow to the brain. Treatment with the intravenous
clot-busting drug tissue plasminogen activator (tPA) can restore blood
flow before major brain damage has occurred, provided the drug is given
within 4.5 hours of the onset of the stroke. But in many patients,
intravenous tPA alone is not sufficient to restore blood flow. In such
cases, mechanical devices deployed with catheters can be used to remove
the clot from a cerebral artery.
The latest mechanical device is a stent retriever. The device is a
self-expanding mesh tube attached to a wire, which is guided through a
catheter. The physician inserts the catheter in an artery in the groin
and guides it through various blood vessels up to the blood clot in the
brain. The stent retriever pushes the gelatinous blood clot against the
wall of the blood vessel, immediately restoring blood flow. The stent
retriever then is used to grab the clot, which is pulled out when the
physician removes the catheter. This technique is known as an
endovascular treatment.
Dr.
Biller said intravenous tPA remains the first-line therapy for treating
appropriate patients with acute ischemic strokes. "In carefully
selected patients, endovascular treatment with a stent retriever can
provide additional benefit," Dr. Biller said.
After reviewing results of six recent randomized clinical trials, the
AHA/ASA expert panel recommended endovascular treatment for patients
who are at least 18 years old; have suffered an acute, severe ischemic
stroke; have a clot blocking a large artery supplying blood flow to the
anterior circulation of the brain; and meet other criteria.
The guidelines say endovascular treatment is quite effective if begun within six hours of the onset of an acute ischemic stroke.
"Time is brain," Dr. Biller said. "In the right patient, treatment
with intravenous tPA and a stent retriever potentially can reduce stroke
damage significantly. Every effort should be made to treat these
patients as early as possible by a multidisciplinary and integrated team
of experts."
No comments:
Post a Comment