Doctors have started treating stroke patients with a tiny new device that grabs blood clots blocking arteries within the brain.
The procedure, called mechanical thrombectomy, involves threading a catheter tube through an artery in the groin up to the clot that’s blocking oxygen from reaching the brain. Once there, the tiny, wire mesh cage snatches up the clot, traps it, and the device is pulled back out. The thrombectomy should be performed within six hours of acute stroke symptoms and only after the patient first receives a clot-busting drug called tissue plasminogen activator, or tPA.
Earlier this week, the American Heart Association and the American Stroke Association issued guidelines that urged doctors to use this approach for treating the worst kinds of strokes. The recommendation comes after five studies were published in New England Journal of Medicine over the last six months showing how the treatment improves the chances that certain stroke patients will not only survive but also function normally again.
The clot-busting drug tPA, which was approved by the U.S. Food and Drug Administration back in 1996, is effective when given intravenously within 4.5 hours. But it doesn’t completely dissolve clots in larger arteries. While these cases occur in only a fraction of the 690,000 Americans who suffer a clot-induced stroke every year, the larger clots are often the most deadly and disabling.
At least two of these so-called stent retrievers (or “stentrievers”) have been FDA-approved since 2012: Solitaire by Medtronic and Trevo by Stryker. These newer stents are safer and more effective than older devices, which resembled a corkscrew.
“Everything is different than it was a year ago,” William Powers from the University of North Carolina at Chapel Hill says in a statement. He led the panel that wrote the new guidelines. Stent retrievers are already being used across the U.S., and up to 13,000 thrombectomies were performed in the country last year.
According to the American Stroke Association, the telltale warning signs of stroke include: face drooping, arm weakness, and speech difficulty. Patient showing these symptoms should be rushed to a hospital in order to receive tPA. “Once that’s done,” Powers adds, “the question we should all now be asking is, will the patient benefit from this additional treatment?”