About 85 percent of strokes are ischemic
The latest mechanical device is a stent retriever. The device is a self-expanding mesh tube attached to a wire, which is guided through a catheter. The physician inserts the catheter in an artery in the groin and guides it through various blood vessels up to the blood clot in the brain. The stent retriever pushes the gelatinous blood clot against the wall of the blood vessel, immediately restoring blood flow. The stent retriever then is used to grab the clot, which is pulled out when the physician removes the catheter. This technique is known as an endovascular treatment. Dr. Biller said intravenous tPA remains the first-line therapy for treating appropriate patients with acute ischemic strokes. “In carefully selected patients, endovascular treatment with a stent retriever can provide additional benefit,” Dr. Biller said. After reviewing results of six recent randomized clinical trials, the AHA/ASA expert panel recommended endovascular treatment for patients who are at least 18 years old; have suffered an acute, severe ischemic stroke; have a clot blocking a large artery supplying blood flow to the anterior circulation of the brain; and meet other criteria. The guidelines say endovascular treatment is quite effective if begun within six hours of the onset of an acute ischemic stroke.