Finding the answer to aiding stroke recovery
Answers on how best to improve the quality and speed of a stroke patient’s recovery may lie in their blood pressure.
Led by anaesthetist Dr Doug Campbell, a group of anaesthetists, radiologists and neurologists are on a mission to discover the blood pressure ‘‘sweet spot’’ during stroke surgery.
The research comes on the back of a new and ‘‘miraculous’’ clot retrieval procedure that has been making stroke treatment more accessible and improving New Zealanders’ quality of life.
With the procedure, an ischaemic stroke – caused by a blood clot – can be halted and even reversed using a meshlike retrieval device if a patient is able to be treated within six hours.
The surgery has already resulted in some patients, who were facing paralysis, being able to walk away from a serious stroke with little or no disability. Buoyed by the success so far, 550 postsurgery patients are being monitored for three months to gauge their recovery and, ultimately, reveal where blood pressure should be maintained during surgery for the best results.
‘‘There was some earlier research that suggested that those people who have general anaesthesia during surgery were doing worse. That could be down to a lot of things, but we know patients under a general [anaesthetic] have lower blood pressure.
‘‘If low blood pressure is harmful, then you’ve got to wonder whether putting the blood pressure up higher when having an anaesthetic could be beneficial,’’ Campbell said.
Over the next three years, participating stroke patients in Wellington, Auckland and Christchurch would have their recovery process tracked.
This would give the researchers time to compile enough information to form a conclusion.
Campbell said it was the first time a multi-centre trial had looked at the impact on blood pressure where the clot is removed through a mesh-like device inserted through the femoral artery in the groin, to the brain.
The procedure had already helped expand the ‘‘golden window’’ – when doctors were able to minimise or prevent permanent damage by removing the clots directly from the brain – from six hours to 24 hours following a stroke.
Stroke is currently New Zealand’s second-largest killer with about 2000 people dying each year. There are estimated to be around 60,000 stroke survivors nationwide.
‘‘If low blood pressure is harmful, then you’ve got to wonder whether putting the blood pressure up higher when having an anaesthetic could be beneficial.’’
Anaesthetist Dr Doug Campbell