When a stroke hits, every second counts. Oxygen stops flowing to the brain, and irreversible damage is done with every second that passes. When a vessel that supplies blood to the brain becomes blocked, doctors fight the blockage with clot-busting drugs, or try to clean it out with a corkscrew-like device that breaks up the clot.
Dr. Italo Linfante presented a paper on Monday that said using Sleeve-Like stents saved the lives of several patients who couldn’t be successfully treated by other methods. When a person’s heart arteries are clogged, it’s relatively routine to open them with a probe, then leave a sleeve-like mesh stent to hold the artery open. It’s a much newer technique to use stents to combat a stroke, which is caused by a blood clot blocking an artery in the brain.
Fred Tasker of The Miami Herald reported that In the Baptist study, Dr. Linfante chose 19 acute stroke patients who hadn’t been helped by drugs or corkscrew devices and used a stent to combat the blockage. In his study, the stent opened the arteries of 18 of the 19 patients, who otherwise could have been disabled or died.
The stent is a metallic mesh sleeve mounted on a tube. When it is pushed into the clot, it pokes a hole in it. Then the mesh is expanded, pushing the rest of the clot against the walls of the artery. The restored blood flow dissolves the rest of the clot; the stent is sometimes then removed, or left in place to hold the artery open.
”Our findings suggest stents can work when clot busting drugs and clot removal devices do not, and are a safe and feasible option,” he said.
Dr. Linfante is applying for approval from the Federal Drug Administration for human clinical trials of the device. Use in the general public is about five years away, he said.
The key to the study appears to be the quote from Dr. Infante that: “Our findings suggest stents can work when clot busting drugs and clot removal devices do not, and are a safe and feasible option.”
Currently, treatment for a ischemic stroke is with the drug known as tPA, which stands for “Tissue Plasminogen Activator.”
Tissue plasminogen activator (tPA) is a thrombolytic agent (clot-busting drug). It’s approved for use in certain patients having a heart attack or stroke. The drug can dissolve blood clots, which cause most heart attacks and strokes. tPA is the only drug approved by the U.S. Food and Drug Administration for the acute (urgent) treatment of ischemic stroke.
In 1996 the U.S. Food and Drug Administration (FDA) approved the use of tPA to treat ischemic stroke in the first three hours after the start of symptoms. This makes it very important for people who think they’re having a stroke to seek help immediately. If given promptly, tPA can significantly reduce the effects of stroke and reduce permanent disability. tPA can only be given to a person within the first three hours after the start of stroke symptoms.
tPA or other thrombolytics can reduce disability from a heart attack or stroke, but there is also a higher risk of bleeding.
Thus, If Dr. Infante’s procedure can treat that patient who is otherwise outside the three hour window, it would be a significant medical advance.
The American Heart Association has a very informative site on the warning signs of Stroke