Catheter-Based Therapies May Benefit Stroke Patients

Option appears safe and effective after ischemic stroke in patients not eligible for IV thrombolysis

04 april 2009-- In some patients who aren't candidates for intravenous thrombolysis, catheter-based therapy (CBT) provides an optional treatment for acute ischemic stroke, according to research published in the April 1 issue of Catheterization and Cardiovascular Interventions.

James T. DeVries, M.D., of the Ochsner Heart and Vascular Institute in New Orleans, and colleagues analyzed data from 26 patients with acute ischemic stroke who underwent CBT, including intra-arterial thrombolysis, balloon angioplasty, stent placement, guidewire thrombus disruption, mechanical embolectomy, or combinations of these. Patients were ineligible for intravenous thrombolysis.

In 88 percent of the patients, culprit artery recanalization was successfully accomplished. In-hospital adverse events -- mostly intracerebral hemorrhage -- occurred in 15 percent of patients. Half of the patients achieved a modified Rankin score of two or less, indicating mild disability, the researchers found.

"Our data suggest that CBT for severe, disabling acute stroke is an important and effective treatment for selected patients not eligible for intravenous thrombolysis," the authors conclude. "The 'time is brain' paradigm requires that 24 hour a day, 365 days a year 'CBT stroke teams' are available for patients with acute stroke who are not candidates for intravenous thrombolysis. To that end, it will be necessary to create multidisciplinary teams consisting of experienced carotid stent operators and stroke specialists to improve the quality of care and outcomes for patients presenting with acute stroke."

Abstract
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