New way to pluck a blood clot from your brain

Anew technique to remove blood clots from the brains of stroke victims could almost double the number who make a full recovery. Clots obstructing blood flow to the brain are the most common cause of strokes, and the longer the clot is there, the higher the risk of irreversible brain damage.

The new treatment involves inserting a small stent, a tiny tube-like wire mesh, into an artery to retrieve the clot. This tiny cage effectively grabs the clot, pulling it out of the brain.

Provided it is done within six hours of the stroke, full blood flow is resumed and the risk of damage is reduced.

A recent study of 500 patients found a major reduction in disability among patients who had the intra-arterial treatment, also known as thrombectomy. One in three managed to return to full mobility whereas normally only one in five receiving existing treatments do.

Strokes affect 152,000 Britons each year and are the largest cause of adult disability in the UK.

There are drugs that can disperse the clots that cause ischaemic strokes, as they are known. But some patients do not respond, especially when there is a big clot blocking a large artery.

The new procedure uses a stent to trap the clot and pull it out of the brain via a tiny tube, or catheter, inserted through an incision in the groin.

It is guided to the clot with X-ray imaging technology.

Thetrial of the new technique compared two groups of patients, all of whom received clotdissolving drugs.

Around half were also treated with the retrievable stent.

The study, carried out in the netherlands between December 2010 and March 2014 in moderate to severe stroke patients, found 33 per cent of those treated with the stent regained independence, compared with 19 per cent of those getting standard care.

The new procedure was effective and safe, according to results published in the new england Journal of Medicine.

Dr Sanjeev nayak, of the University hospitals of north Midlands nhS Trust, has carried out 200 of the procedures, and says: ‘I have personally seen how this treatment can change the course of a patient’s life.

‘These findings are going to change the entire way that stroke is treated across the world.’

Dr nayak estimates that 10 per cent of patients having an ischaemic stroke, about 10,000 in the UK a year, would benefit.

‘These are patients with the worst potential outcome because they have large clots barely touched by clot-dissolving drugs,’ he adds. ‘At our centre 50 per cent of patients get back functional independence.’ Dr Shamim Quad i r, research communi- cations manager at the Stroke Association, described the new technique as ‘an extremely exciting field of stroke research’.

‘Thrombolysis (the use of clotbusting drugs) is the only proven treatment which can limit the damage caused by acute ischaemic stroke,’ he says. ‘But it must be administered within 4 ½ hours, and benefits around one in seven people treated.

‘The study suggests that the procedure can be used to help these patients when used within six hours of stroke onset in addition to thrombolysis.’

MeAnwhILe scientists are testing whether taking blood pressure pills in the evening rather than the morning may be more effective at reducing the risk of strokes and heart attacks.

Patients traditionally take their tablets in the morning when blood pressure tends to be highest.

But some studies have suggested swapping to night is a better way to reduce blood pressure and associated risks. Blood pressure drops naturally as we sleep and the theory is that taking the medication at night increases this effect.

now more than 10,000 people across the UK are taking part in a trial run by Dundee University which could lead to changes in the times hypertension drugs are taken.