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Clot removal even after 6 hrs can improve quality of life post stroke

Clot removal beyond the initial 6hrs improves quality of life after stroke

Clot removal beyond the initial 6 hrs improved overall quality of life including mobility when compare to those treated with drugs alone, finds a new study.

Stroke survivors have better quality of life three months after their stroke if the clot that caused the stroke was mechanically removed even hours beyond the ideal treatment window compared to those treated with drugs alone. This preliminary research was presented in Honolulu at the American Stroke Association’s International Stroke Conference 2019.

Ischemic stroke is the most common form of stroke (85%) and it occurs when blood stops flowing to a part of the brain due to a clot or thrombus. This interruption in blood flow leads to damage to the surrounding brain cells. The effects of a stroke depend on the part of the brain that was damaged and the amount of damage caused by a sudden blocked artery. This sudden obstruction in blood flow due to the clot or thrombus can be reversed by administration of a ‘clot busting’ drug, also called thrombolysis or mechanically removing the clot (endovascular therapy) in the initial 4.5 to 6 hours.

Stroke is the second leading cause of death and disability globally but in India stroke is the fifth leading cause of death, according to the first state level disease burden study 2017

Stroke is the second leading cause of death and disability globally but in India stroke is the fifth leading cause of death, according to the first state level disease burden study 2017.

Researchers have found that mechanically removing a clot in stroke patients can limit disability from stroke. While the therapy is most effective when performed within six hours of symptom onset, it can also reduce functional deficits in patients up to 24 hours after stroke symptoms start.

In the DEFUSE 3 trial, Stanford University School of Medicine researchers studied whether stroke survivors who were treated with endovascular therapy in the late six-to-16-hour time window might have better quality of life than people treated only with standard drug therapy. They examined a subset of ischemic stroke patients who had salvageable tissue visible on brain imaging.

Researchers surveyed patients 90 days after stroke about their mobility, ability to participate in social activities, cognitive (or thinking) function and depression.

Based on results from 136 patients who completed all or some of the surveys, people treated with endovascular therapy had superior quality-of-life results in all four domains, compared to those who had medical therapy alone.

“In addition to improved functional outcomes, endovascular therapy six to 16 hours after onset preserves mental health and social capabilities critical to patients’ quality of life,” researchers said.

Dr O P Choudhury
Dr O P Choudhury
Dr O P Choudhury is a founding member and the editor of MediBulletin.com. A practising doctor for the last 22 years, he has been working in the neurology department of Indraprastha Apollo Hospitals for more than ten years. You can contact him at: dr.opchoudhury@medibulletin.com
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