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Pitt: New stroke treatment could reduce number of deaths

Thousands of people might survive a stroke with a clot-killing method explored in part at the University of Pittsburgh, according to an international study released Wednesday.

The death rate dropped to 10 percent from 20 percent when doctors used an innovative stent approach on more than 300 stroke patients with clots blocking blood flow to the brain, researchers said. Overall positive outcomes jumped to 55 percent from 30 percent with the therapy, which sends a thin tube and retrievable stent through the aorta and into brain vessels, according to Pitt.

“We call it a game-changer because, up until now, there’s only been one proven, effective therapy for acute stroke,” said Dr. Lawrence Wechsler, a study co-investigator and the neurology chairman at Pitt and UPMC.

The other therapy, an intravenous medicine used to dissolve clots, gained momentum in the mid-1990s and has become a standard treatment for clots lodged in the brain. Strokes caused by such clots strike about 800,000 people in the United States each year.

Those who received brain stents, called endovascular treatment, had a lower risk of disabilities and better odds of living independently after surviving a stroke, doctors said at an American Stroke Association conference in Nashville.

“This is a once-in-a-generation advance in stroke care,” said Dr. Jeffrey Saver, stroke chief at the University of California, Los Angeles, who looked into the technology.

It’s similar in principle to the stents that prop open clogged heart arteries. The brain stent differs because doctors remove the stent along with the clot.

In Pittsburgh, UPMC enrolled two dozen patients in the project, findings from which appear online in the New England Journal of Medicine. Doctors said it’s one of several studies that illustrate the method’s effectiveness.

Some reviews of the therapy stopped early because the concept is so effective, researchers said.

“We’re learning that the sooner this treatment is administered, the better the outcomes,” said Dr. Tudor Jovin, a UPMC neurology specialist who led the Pitt arm of the research.

He expects new mandates will direct medics to take patients who could be helped by the approach to medical centers that offer endovascular treatments. Hospitals in Western Pennsylvania with the equipment include UPMC Presbyterian in Oakland and Allegheny General Hospital in the North Side, doctors said.

They emphasized the discoveries show better results only for some patients with acute ischemic stroke, which involves blockages that deprive the brain of key nutrients. Wechsler estimated 15 percent to 20 percent of stroke patients might benefit.

Doctors developed the idea in the 1990s, but it only recently became technically feasible, according to Pitt.

Study participants spanned 22 sites around the world, including in Canada, Ireland and South Korea. It was based at the University of Calgary, with funding from the Heart and Stroke Foundation of Canada, Medtronic and other sources.

The Associated Press and Reuters contributed to this report. Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or [email protected].


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