The society of neurointerventional surgery has released details on three studies, including research on the life saving treatment for stroke thrombectomy.
Study #1
‘Giving Patients Antiplatelet Medication Sooner After Stroke Treatment May Significantly Improve Patient Recovery’
Administering antiplatelet medication within 24 hours of mechanical thrombectomy, an effective procedure for stroke, may help patients make a more successful recovery and prevent high-risk individuals from experiencing additional strokes.
Antiplatelet medication helps to prevent blood clots from forming (and potentially causing strokes) by keeping platelets from sticking together. However, this medication can also potentially cause brain bleeding if administered soon after mechanical thrombectomy.
In order to find a way to safely use this essential medication without causing additional risk to patients, researchers reviewed data from 190 patients who underwent this treatment between 2016–2020 and categorised patients by those who received antiplatelet medication less than 24 hours after surgery and those who received the medication later.
In this study, researchers highlighted that patients who received antiplatelet medication within 24 hours of mechanical thrombectomy were significantly more physically independent at discharge from the hospital than patients who received the antiplatelet medication later.
This difference was maintained longer-term as well, with patients who received early antiplatelet medication having much better physical functioning scores one month and three months after surgery. In addition, there was no sign that giving patients antiplatelet medication earlier led to increased risk of brain bleeding after surgery.
Lead author of this study, Dr Hepzibha Alexander, says: “Continuously working to improve patient outcomes is one of our top priorities.
“Finding a new way to safely use this already-essential medication is an exciting step forward in helping patients thrive after stroke.”
Study #2
‘New Stroke Surgery Eligibility Criteria May Dramatically Increase Lifesaving Stroke Surgery Rates, with Nationwide Implications’
This study highlights that U.S. rates of endovascular thrombectomy, a lifesaving stroke treatment, are projected to increase dramatically based on new criteria.
In the study, endovascular thrombectomy was shown to improve clinical outcomes in patients with large ischemic strokes. This change has the potential to affect hospitals across the country and require new planning efforts to accommodate these additional patient needs.
Recent studies have suggested that endovascular thrombectomy is a viable option for treating large ischaemic strokes, opening up the potential for more people to receive this care.
The researchers in this study reviewed nationwide hospital admission data from 2016–2019 for people who were classified as having an ischaemic stroke.
By using the new eligibility criteria for large ischaemic strokes, they then re-classified some patients who did not receive stroke surgery as new candidates for the surgery.
According to the study authors’ projections, this new eligibility criteria could increase rates of thrombectomy surgery in the U.S. by 14 per cent–37 per cent. These additional surgeries present new opportunities for patients to get the correct care, however, it also may prove difficult to manage for hospitals without sufficient neurointerventionalists on staff to perform these surgeries.
Lead author of the study, Dr Osman Mir, says: “These outcomes are inspiring, and this information gives us an important opportunity to evaluate current stroke treatment efforts across the country.
“In addition, these numbers clearly show that we need to invest more fully in our capacity to ensure that every stroke patient across the U.S. can access this high-quality treatment if—or when—they need it.”
Study #3
‘Research Shows Filter Tip Stent Retrievers May Allow Neurointerventionalists to Remove Blood Clots on the First Try During Stroke Treatment’
New research shows that different types of stent retriever tips may result in improved patient outcomes when performing mechanical thrombectomy to treat stroke.
By using the minimally invasive procedure mechanical thrombectomy, neurointerventionalists can restore blood flow to the brain by removing blood clots using tiny mesh tools called stent retrievers.
However, if a neurointerventionalist cannot remove the entire blood clot on the first try due to clot fragmentation, multiple additional retrieval attempts may be required, which lead to longer procedural times and worse clinical outcomes.
In this study, researchers in Spain created a model of the brain arterial system and used several types of stent retrievers (open tip, closed tip, and filter tip) to remove the blood clot simulants.
They simulated 50 mechanical thrombectomies per each type of stent retriever, finding that the filter tip stent retriever allowed them to fully retrieve the clot simulant in one try 44 per cent of the time, compared to 16 per cent of the time for open tip retrievers and 20 per cent of the time for closed tip retrievers.
Lead author of the study, Jiahui Li, says: “It’s essential to continuously refine devices and techniques to improve stroke treatment.
“Each clinical scenario demands specific tools and treatment approaches. Hopefully, this research will aid in evaluating the suitability of different devices for each stroke case, thus giving patients a better chance at recovery and functional independence.”
