A new study has found more stroke victims may be saved from disability or death if doctors can remove blood clots that block circulation to the brain. It also found doctors may have more time than originally thought to perform the treatment.
“We’ve been trying to push the envelope for the past several years. We’ve done a lot of studies to increase the time window,” Dr. Farhan Siddiq said.
The endovascular neurosurgeon with Texas Health Fort Worth and Texas Health Physicians Group says that initial time window for treating stroke was about three hours. But Siddiq says recent studies and advances in treatment therapies have expanded that window now to as long as 24 hours.
But while doctors have more time for treatment, Siddiq says patients still need to be brought in for care as soon as possible.
“You’re losing several million brain cells per minute when you have a stroke — something that we want to prevent,” he said.
Interview responses have been lightly edited for clarity.
On the expanded stroke treatment window: When an artery is occluded, there is lack of blood flow to that part of the brain, and brain cells are very sensitive. Traditionally, we think it only takes about three minutes for a brain cell to suffer irreversible damage. However, we are now finding that even though the main artery is occluded, there may be some collateral circulation keeping those brain cells alive for a period longer than what we thought initially. We need to find those patients who have those collaterals in their brain that are keeping the brain cells hypofunction, but still alive. Those are the patients who will benefit.
On the next phase (endovascular therapy): We go in through the groin and put a small microcatheter and a stent-like device across the clot, and then use that device and the suction to pull out the clot. With the new devices, we’ve been very successful in removing more than 85 percent of those clots. The success rate and the ease of deployment has improved a lot of stroke care.
On the impact of the treatment studies: The guidelines for treating stroke are changing. In most of the hospitals that are up to date, and even in our hospital, protocols have changed. We’re moving toward enrolling patients for up to 24 hours. Even though we can extend a window period to 24 hours, the sooner the patients present, the better care they can get and the more we can be effective in improving their quality of life afterwards.