A large EU-funded study with the participation of experts from Graz has now shown that removing the causative blood clot with a catheter intervention in severe strokes can save lives.”Treatment using a catheter to open the vascular occlusion is also successful in patients with severe strokes “In almost 20 percent of the patients treated, death or the need for care could be prevented through an appropriate procedure,” reported the Hamburg University Hospital (UKE).
Around 20 years ago, it began to be used to dissolve these thrombi using medication in the case of ischemic strokes (blood clots in a brain vessel). This alone led to significantly better treatment results because permanent damage can be prevented by quickly restoring oxygen supply to the brain. In recent years, catheter procedures to mechanically remove the clot have become increasingly common. The best results are achieved with all treatments if they are carried out within four and a half or six hours of the onset of symptoms – i.e. as quickly as possible.
But development continues. “The TENSION study, funded by the European Union with six million euros, was carried out in 40 stroke centers in eight European countries and in Canada. The study examined the treatment of patients with an acute ischemic stroke (cerebral infarction) caused by a large vascular occlusion had already led to a larger infarct core,” wrote the Hamburg clinic. Also involved in the study Hannes Deutschmann of the Clinical Department of Neuroradiology MedUni Graz participated as a co-author.
Great advantages of catheter treatment
Until now, catheter treatment of stroke patients was mainly carried out on those affected in whom little brain tissue had been damaged by the vascular occlusion. In addition, the time window for therapy was usually limited. In the study, treatment was also carried out up to twelve hours after the onset of symptoms.
In the study, the patients were randomly assigned to either a group with conventional standard therapy (thrombolysis via medication, etc.) or additionally with catheter treatment. “In this so-called endovascular thrombectomy, doctors advance a catheter from the groin into the arteries of the brain under X-ray control in order to then remove the blood clot that caused the vascular occlusion,” said the Hamburg University Hospital, describing the procedure.
The first interim evaluation already showed major advantages of catheter treatment. When evaluating the course of the illness of 253 patients after 90 days, significantly more of them did not need long-term help after the stroke (two percent compared to 17 percent); 31 percent were able to walk independently (compared to 13 percent in the comparison group with drug treatment alone).
29 percent lower mortality
“The proportion of patients who died or required care as a result of the stroke was almost 20 percent lower in the group with catheter therapy (69 versus 87 percent), and the number of deaths was eleven percent lower (40 versus 51 percent) “said the scientists.
“The results of the TENSION study show that catheter treatment is effective even in the case of severe strokes. This treatment method can help the affected patients develop fewer sequelae and lead a more independent life. On this basis, standard therapy can be used for severe strokes Strokes should be expanded and patient care improved,” study coordinator Götz Thomalla, director of the UKE’s Neurology Clinic and Polyclinic, was quoted as saying.
Due to the early proven effectiveness of endovascular thrombectomy in severe strokes, the study was ended prematurely after the first planned interim analysis. It was presented at the recent World Stroke Congress in Toronto and published in the medical journal The Lancet. In Austria, around 25,000 people suffer a stroke every year.
Text credit: APA Science from October 16, 2023
2023-10-20 07:10:12
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