Clot-removing treatment can benefit more stroke patients

TIME IS BRAIN. That’s long been the message from stroke experts — that faster is better when it comes to how quickly people with stroke symptoms get emergency treatment. It’s still the best advice. But unfortunately, many stroke patients fail to get emergency care within the recommended window of time.

Now a large new study finds that more people than previously thought can benefit from an emergency clot-removal procedure for the most common type of strokes, and that some patients saw significant improvement even as long as 16 hours from the start of symptoms.

Previously, it was thought that patients had a six-hour window of time for the procedure to be helpful. The study, known as DEFUSE 3, was published this week in the New England Journal of Medicine.

“Nearly half of all patients treated between six and 16 hours after the onset of their symptoms were largely spared from the consequences of their stroke,” Dr. Gregory Albers, director of the Stanford Stroke Center at Stanford Medicine in California, and principle investigator of the DEFUSE 3 study, said in a written statement.

Those improved outcomes were a result of advanced brain imaging that helps identify stroke patients who might benefit from the clot-removal therapy known as thrombectomy.

Dr. Lee Birnbaum, associate professor of neurology and neurosurgery at UT Health San Antonio and medical director of University Health System’s comprehensive stroke center, noted the study’s benefits included older adults. The study found the number of stroke patients who died or required nursing home care was reduced by nearly half.

“The results of DEFUSE 3 not only add to the overwhelming evidence that mechanical thrombectomy for acute stroke saves lives and reduces disability but also expands its indication to milder strokes and older patients,” Dr. Birnbaum said. “As a comprehensive stroke center, the University Hospital stroke team utilizes advanced neuroimaging with CT to identify patients who qualify for this therapy, and performs this life-saving therapy around the clock, 365 days a year.”

Ischemic strokes make up about 85 percent of all strokes. They occur when a blood clot cuts off the blood supply to the brain, starving brain cells of oxygen and glucose.

The word “FAST” is used to help people remember the symptoms of a possible stroke, and what to do when they occur. FAST is short for:

  • Face (facial droop or uneven smile)
  • Arms (numbness or weakness)
  • Speech (slurred speech, difficulty speaking or understanding)
  • Time (Call 911 immediately if symptoms occur; time is critical in seeking help)

And even though the new study suggests a longer window of time is effective, Dr. Birnbaum encourages patients with stroke symptoms to seek help immediately.

“Even though DEFUSE 3 showed benefit up to 16 hours, remember that “Time is Brain,” act “FAST” and call 911,” Dr. Birnbaum said.