Post-Stroke Treatment May Help For Up to 24 Hours

January 10th, 2018

A surgical procedure to remove clots from blocked brain vessels—known as thrombectomy—may help some stroke patients beyond the six-hour treatment window that current guidelines recommend, according to a groundbreaking new study published in the New England Journal of Medicine. During an ischemic stroke, a clot blocks a blood vessel in the brain. Without blood and the oxygen it carries, part of the brain starts to die and brain damage can begin within minutes. To restore blood flow and minimize damage, treatment to break up or remove the clot with medication or surgery must begin as soon as possible. Thrombectomy is known to improve outcomes for some stroke patients but the six-hour treatment window can present a treatment barrier.  

In the study, researchers randomly assigned participants who arrived at the hospital between 6 and 24 hours post-stroke to either thrombectomy or to standard medical therapy with medication. The results showed that almost half of the patients (48.6 percent) receiving thrombectomy had a good outcome (defined as the patient being independent in activities of daily living at 90 days after treatment), while only 13.1 percent showed benefit in the group that received clot-busting drugs alone. “When the irreversibly damaged brain area affected by the stroke is small, we see that clot removal can make a significant positive difference, even if performed outside the six hour window,” said University of Pittsburgh researcher Tudor Jovin, MD, who co-led the trial. “However, this does not diminish urgency with which patients must be rushed to the ER in the event of a stroke. The mantra ‘time is brain’ still holds true.”

Learn more about stroke research studies at Pitt+Me.