Stent retriever improves outcomes for stroke patients

Stroke is a leading cause of death and disability in India, largely driven by the increasing prevalence of diabetes, high blood pressure and obesity.

Stroke affects men and women and does not discriminate on the basis of age; the young are equally at risk of stroke as are older people. A stroke can be devastating at any age.

It is commonly observed that stroke patients do not realise the gravity of early signs and symptoms, and tend to delay treatment until more ‘dramatic’ symptoms are present.

Even more critical is that most of these early stroke cases wait to see if the symptoms will go away on their own. Stroke is treatable and its impact can be significantly reduced, provided the patient receives medical treatment in time.

About 85 percent of the time, the cause of a stroke is a clot that blocks an artery and restricts blood flow to the brain, or an acute ischemic stroke.

Because brain tissue begins to die immediately when blood flow is deprived, it is critical to open the artery quickly. In treating stroke it is critically important to restore blood flow as soon as possible.

Until recently, physicians have been using intravenous tPA(Tissue plasminogen activator), a clot-busting drug to open blocked blood vessels, as the first line of defense.

Five global clinical trials published in 2015 have shown that the addition of stent retriever therapy to IV-tPA improves functional disability in patients and is now recommended as a first-line treatment for acute ischemic strokes.

Stent retrievers are inserted via a catheters through a pin hole in the groin area to the targeted vessel in the brain, where it is used to manually remove the clot and re-establish blood flow. The stent retriever is then removed from the patient.

Stent retrievers are a major advance in stroke care. The addition of stent retriever technology has reduced disability, improved neurological outcomes and increased the rate of return to functional independence in patients suffering from ischemic stroke.

Stent retrieval therapy for acute ischemic stroke patients is a very promising approach that is now being used at leading hospitals across India.

A growing number of specialists have developed or are developing the expertise to perform these procedures.

By: Dr Rajesh Reddy, Brain, Spine & Endovascular Neurosurgeon, Apollo Institute of Neurosciences, Hyderabad