Researchers show 'clot-busting' at stroke site is viable option

COLUMBUS, Ohio A small Ohio study has offered the first published evidence that aggressively treating brain blood clots at their source soon after symptoms start can produce a good outcome for many stroke patients.

In the study, published in a recent issue of the journal Neurosurgery, 50 percent of stroke patients had little or no neurological disability one to three months after clot-dissolving medication was delivered directly to the site of the blockages, compared to 39 percent of patients with similarly good outcomes documented in a large national trial of intravenous (IV) drug treatment for stroke. In all cases, time was an issue: The drugs in both trials were administered within three hours of the onset of symptoms.

"The results tell us what many of us suspected that targeting the problem and delivering drugs right to the problem is a better option for appropriate stroke patients," said Eric Bourekas, an interventional neuroradiologist at Ohio State University Medical Center and lead author of the study.

Researchers at OSU Medical Center and Case Western Reserve University compared patient outcomes from their institutions to the outcomes reported in 1995 after a study led by the National Institute of Neurological Disorders and Stroke. In that large trial, patients who were treated intravenously with recombinant tissue plasminogen activator (rt-PA) within three hours of symptom onset were at least 30 percent more likely to have good outcomes compared to patients on placebo. That study led to the intravenous use of rt-PA as the only federally approved clot-dissolving treatment of ischemic stroke the roughly 80 percent of strokes caused by blockage of a blood vessel.

The two Ohio centers treated hundreds of stroke patients using the intra-arterial (IA) method of drug delivery over the time period observed, between 1993 and 2002, but only 36 patients received the medication within three hours after symptoms began, matching

Contact: Emily Caldwell
Ohio State University

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