New ray of hope for acute ischaemic stroke patients

May 06, 2019

There is a new ray of hope for acute ischaemic stroke patients with the advent of endovascular neurosurgery, said Dr. Maqsood Ahmed, Consultant\Interventional neurosurgeon, Columbia Asia Hospital, Mysuru.

Delivering a talk on Stroke and its Emergency Management at Columbia Asia Hospital, he said, "Endovascular neurosurgery is a minimally invasive procedure done with a small opening in the thigh. Wires and narrow catheters are then passed through the blood vessels to reach the brain arteries which are blocked and then we try to open up the clot, thereby re-establishing the blood flow. Specially designed wires with a spring like expandable distal (stent retrievers) end are passed across the clot. The clot gets entangled in the stent and this is pulled out with the application of suction. This procedure called 'Mechanical thrombectomy' can be used upto 6-8 hrs and in some cases upto 24 hours after an acute ischaemic stroke. However, the earlier the treatment, the better are the results. Acute stroke management is a team work of many allied medical specialties like emergency medicine, stroke neurologist, endovascular neurosurgeon and a good ICU team."

"The symptoms of acute stroke can be classified as 'FAST' wherein F is a facial asymmetry or drooling of the face, A stands for sudden weakness in the arm, S for slurring of the speech and T for time to quickly call the ambulance/emergency services. If we follow these steps and shift the patient to the right centre in a stipulated time frame, there are chances that the patients will reverse their strokes and avoid major morbidity. Hence we can say that “Stoke is reversible" added Dr. Maqsood Ahmed

"Ischaemic stroke is more common than hemorrhagic stroke. Management of stroke has been quite dismal till recently. During 1995, a new drug was introduced called intravenous tissue plasminogen activator (ivTPA) which acted as a clot buster and claimed to open up all blood vessels which have been blocked. This drug was introduced as emergency management with a maximum time limit to administer it four and a half hours after onset of stroke. However, only 8 percent of people with acute stroke were eligible candidates for its administration due to the tight window period and many serious side effects associated with its administration", pointed Dr. Maqsood.