An acute ischemic stroke is the most common type of stroke, accounting for nearly 87 per cent of all stroke cases and occurs when blood flow to the brain becomes disrupted from a blocked blood vessel.
When a stroke occurs, time to treatment is extremely important. Acting quickly to give the patient emergency medical care is a major factor in successfully treating acute stroke.
The primary goal in treating acute ischemic stroke is to restore blood flow to the parts of the brain that have been affected as quickly as possible. It is important to recognise the signs and symptoms of stroke, but also the available treatment options.
With this knowledge, you’ll be better prepared in the event of an emergency.
TREATMENT OPTIONS
When stroke occurs, several different treatment methods are available: lytic drugs and endovascular clot removal. Based on the patient’s symptoms, time to treatment, blockage location and other diagnostic testing, the treating physician will determine the most appropriate method of care.
LYTIC DRUGS
A “clot-busting” medication called tPA attempts to dissolve the clot and is generally the first course of action against stroke if it can be administered to the patient within the first three hours from when the stroke occurred. In instances when tPA fails, when patients are not eligible to receive tPA, or when the size of the clot is too large for the drug to dissolve and remove the blockage, blood flow would not be restored.
ENDOVASCULAR TREATMENT
When a clot occurs in a large vessel, and lytic therapy is not a well-suited option, the treating physician may recommend endovascular (inside the blood vessels) clot removal. This type of treatment is minimally invasive, with a physician accessing the brain through the body’s major blood vessels.
The Trevo™ ProVue Retriever is a tiny medical device, known as a “stent retriever”, designed to remove the blood clot and restore blood flow to the affected areas of the brain. The physician makes a small hole in the femoral artery, located in the upper leg.
The Trevo Retriever is attached to a thin wire and navigated through the body’s blood vessels, into the brain and to the site of the blocked blood vessel to deliver the devices.
When the devices reach the area of the blockage, the physician advances the retriever through the blood clot, and allows the retriever to expand and integrate into the clot. The physician then pulls the retriever containing the clot into a catheter and removes it from the body. Once the clot has been removed, blood flow should be restored to the previously blocked vessels.
STROKE CASE STUDY
Patient presentation: a 77-year-old female arrived at the hospital three hours from symptom onset. She was contraindicated for IV tPA, meaning she was unable to receive the clot-busting drug. The treating physicians decided to take her to the operating room for possible endovascular intervention.
*Results from a single case study are not predictive of results in other cases. Results in other cases may vary.
Stryker Neurovascular stryker.com/emea/neurovascular
