Blood-thinning drugs bring new hope to stroke patients

One of the most miraculous surgical operations is the removal of a blood clot from the brain that’s caused a stroke, an op called a thrombectomy.

But would the prior use of bloodthinning drugs achieve better results than a thrombectomy alone?

An international collaboration of researchers from universities in Bristol, Singapore, Germany, Belgium, Sweden and Taiwan has examined this proposition, and they’ve found better survival rates with the use of blood-thinning drugs.

Thrombectomy is effective in patients with an acute stroke caused by a clot blocking the main artery for the back of the brain, the basilar artery.

Even though giving a blood-thinning drug before removing a clot is recommended, there were no studies that prove it definitely helps.

For instance, in patients with basilar artery occlusion who undergo a thrombectomy, it was not clear whether prior treatment with bloodthinning drugs was beneficial. So the research team wanted to compare the outcomes of the operation with and without intravenous blood-thinning drugs in a basilar artery blockage, and by looking at published results past and present.

Of the total 1,096 patients reviewed, 749 were men and 347 were women. Some 362 patients underwent mechanical thrombectomy with intravenous blood-thinning drugs, while 734 had a simple thrombectomy.

The study found in the patients with acute stroke due to basilar artery occlusion, the intravenous bloodthinning drugs led to lower mortality rates at 90 days than a thrombectomy alone. Blood thinning is also associated with better recuperation, particularly in patients with atherosclerosis, the furring-up of the arteries by the build-up of fat. It’s a potentially serious condition that causes most heart attacks and strokes but often goes unnoticed.

Keng Siang Lee, a medical student and the study’s lead author from Bristol Medical School, said: “Our review has found that in patients with acute ischemic stroke due to basilar artery occlusion, who present up to four-and-a-half hours from the start of their stroke, bridging intravenous thrombolysis could improve their chance of surviving within 90 days.

“If our review is supported in future randomised controlled studies, it could become standard treatment.”

To this end, the research team suggests large future trials should be done to validate whether intravenous blood-thinning drugs provide real benefits over a thrombectomy in stroke patients with basilar artery occlusion. It could improve survival and completely change the outlook for stroke patients.

‘‘ Medication led to lower mortality rates at 90 days than op alone