A meta-analysis has found that the administration of a clot-removal device via the arteries and the use of medical therapy are less likely to result in disability three months after a stroke compared to medical therapy alone.
In a study, published in The Journal of the American Medical Association, Jeffrey Saver and colleagues analyzed five randomized trials. They were able to show that the combination approach offered by second-generation endovascular recanalization treatments are more beneficial than medical therapy alone for acute ischemic stroke patients with blockages in their large vessels.
It wasn't clear, however, if the combination therapy would still show benefit when administered more than six hours after symptoms were observed.
After comparing data from 1,287 patients from across 89 sites in international locations, taking into consideration clinical, demographic and brain imaging information, as well as radiologic and functional outcomes, the researchers found that endovascular thrombectomy (the use of a micro-catheter or other clot-removal device intra-arterially) and medical therapy (the use of a clot-dissolving agent) were associated with less-severe disability at three months, especially when treatment was provided within two hours of symptom onset.
The combination treatment still offered benefit when administered after two hours of symptom onset, but only until 7.3 hours. Beyond that, the treatment's effects became insignificant.
There were 390 patients who experienced substantial blood flow restoration after receiving endovascular thrombectomy, but the researchers observed that for every hour that the procedure was delayed, chances of less functional independence and more severe disability increases although mortality rates remained the same.
Based on their findings, the researchers want to emphasize how important it is to raise patient awareness and promote in-hospital management and out-of-hospital care to reduce the delay between symptom onset and treatment administration.
Earlier in September, researchers from the Case Western Reserve University, the Cleveland Functional Electrical Stimulation Center and the MetroHealth System showed that a new electrical stimulation therapy improved hand dexterity in stroke survivors. Their work also demonstrated that self-administered home therapy can be effective.
Each year, about 800,000 people in the U.S. experience strokes, but another study has found that nine out of 10 cases are actually preventable, if only people took the time to take care of themselves. For instance, addressing high blood pressure, a leading risk factor, can lead to an almost 48-percent drop in the likelihood of experiencing a stroke.
Other risk factors like physical inactivity, lipid levels, poor eating habits and obesity led to 48-, 27-, 23- and 19-percent drops in stroke risk when addressed.
Photo: JE Theriot | Flickr
