The scariest form of stroke involves the pooling of blood in the brain. When this begins, there has been very little that can be done to stop it. Even with open brain surgery, blood often clots so fast that it’s impossible to remove, and an estimated 60 percent to 80 percent of patients who suffer from this condition don’t survive. Of those who do pull through, 90 percent are left severely impaired.
Researchers, however, believe they may have finally found a way to improve a patient’s odds. Speaking at the 2016 International Stroke Conference in Los Angeles, they reported that using a clot-busting heart drug not only appeared to reduce the fatality percentage, it also appeared to increase patients’ chances of a functional recovery, which in the past has been extremely rare.
Issam Awad, a professor of surgery at the University of Chicago who is co-chair of the study, said the therapy could potentially “be the difference between going home instead of going to a nursing home.”
The study involved 500 patients with hemorrhagic or bleeding stroke from 73 sites around the world. Through a brain catheter, they were treated either with saline, which served as the control, or the drug Alteplase, which is known as a tissue plasminogen activator, or tPA, and has been used in people with heart attacks or blood clots near the lungs.
In the five years of follow-up from 2009 to 2015, those who received tPA were 10 percent less likely to die than those who received saline.
In one particular group — those who had high volume bleeds and who responded well to tPA by seeing most of the blood removed — the treatment almost doubled the likelihood of a strong recovery.
Awad said in a release that when the researchers began the study — which is called CLEAR III and is being funded by the National Institute of Neurological Disorders and Stroke and Genentech — they knew very little about who might benefit from this therapy and whether it was even safe.
Now, they said, they know that the most important factor to recovery may be the volume of blood removed and are in the process of educating providers at comprehensive stroke centers around the United States on how the treatment can be used on patients in their care.
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