Study Finds Bigger Treatment Window For Some Stroke Patients

The American Heart Association/American Stroke Association on Wednesday updated its recommendations for the removal of stroke-causing blood clots from major vessels to the brain, saying that select patients can be treated up to 16 hours and, under certain conditions, up to 24 hours after a stroke. The previous recommendation was six hours.

The change, expected to alter the landscape of stroke care, was announced at the American Stroke Association International Stroke Conference in Los Angeles. It came just hours after research was presented showing the success of using advanced CT imaging to identify patients who would benefit from clot removal as many as 16 hours post-stroke. The results come on the heels of another study that showed success treating patients up to 24 hours after a stroke.

The 16-hour update could lead to an estimated 15 to 30 percent increase in patients who would qualify for clot removal, said Dr. Michel Torbey, a neurologist at Ohio State University Wexner Medical Center and one of the authors of the most recent study, which included 13 Wexner patients.

“That is really a significant number given the potential outcome if these patients weren’t treated,” he said. “This is having functional independence versus ending up in a nursing home.”

The study treated 182 stroke patients who had clots in major vessels, were last known to be well between six and 16 hours earlier and had advanced CT scans that showed significant portions of the brain at risk of dying due to oxygen deprivation. Among the patients, 92 had clots removed and 90 did not.

Data showed that 45 percent of patients who had clots removed could function without assistance 90 days after treatment, compared with 17 percent of those who did not have clots removed. Fourteen percent of patients who received the treatment had died, compared with 26 percent of those who did not. Due to the study’s success, researchers cut short the study, which originally called for 476 patients.

Results were published by the New England Journal of Medicine at the same time they were presented at the Stroke Conference. The study was funded by the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

Reference:
http://www.dispatch.com/news/20180124/study-finds-bigger-treatment-window-for-some-stroke-patients