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Medical Video: Endovascular Treatment for Stroke
Endovascular therapy is a type of troke treatment for emergencies. This is a type of interventional treatment, which means that this treatment is in the form of a medical procedure, not a pill or an infusion.
What are the common treatment methods for stroke?
So far, the emergency treatment that is often used for stroke is landfill, which was set about 20 years ago. TPA is a drug called plasminogen tissue activator, a powerful blood thinner that is injected into a blood vessel, usually in the arm.
Drugs quickly flow to the brain where the drug will work by dissolving blood clots that cause ischemic strokes.
The latest and more powerful type of stroke therapy is called intra-arterial thrombolysis, a type of interventional endovascular procedure used to prevent strokes from forming new blood clots.
What is meant by endovascular therapy?
Endovascular therapy is a type of procedure performed by placing a tube called a catheter into a blood vessel. The purpose of intra-arterial therapy is to place a catheter into an artery, which is a blood vessel that is blocked due to a stroke. Meanwhile, thrombolysis is the process of destroying blood clots.
What is intra-arterial thrombolysis?
The intra-arterial thrombolysis procedure for treating strokes must be carried out very quickly, usually within 6-12 hours after the initial symptoms of a stroke appear. In general, intra-arterial thrombolysis requires initial scan studies, such as MRI / MRA in the brain to determine the location of blood clots.
Then, a catheter is inserted into the artery, such as the arm or groin. A catheter containing a strong blood thinning drug is called alteplase. The catheter is then carefully and progressively infiltrated along the way to the blocked arteries of the brain to reach a blood clot. Instantly blood thinners will dissolve the blood clots that are there.
Experienced doctors must carry out this complex procedure and their preparation by involving a team of neurologists, radiologists and possible surgeons.
What is MR CLEAN?
The Dutch Heart Foundation and other organizations help fund the latest research trials called MR CLEAN in the Netherlands. This study aims to evaluate the effectiveness and safety of the intra-arterial thrombolysis method for the treatment of stroke. The results of the trial were published in January 2015 by the New England Journal of Medicine, which involved 500 stroke patients from 16 health centers in the Netherlands.
Of the 500 stroke patients, 233 of whom underwent intra-arterial thrombolysis and 267 people underwent regular stroke treatment. The results showed that patients who underwent thrombolysis had better functional results with a measure of modified Rankin scores — a rating system that refers to one's independence after a stroke. Intra-arterial thrombolysis groups did not experience excessive side effects compared to groups that did not undergo thrombolysis.
What is the importance of this treatment for me?
If you have a stroke, intra-arterial thrombolysis is the only option if you arrive at the hospital a few hours after the initial symptoms of a stroke appear. There are strict rules regarding intra-arterial thrombolysis procedures for security reasons. If you are eligible for intra-arterial thrombolysis, you or a family member must give approval for the procedure. However, there is not much time for doubt in decision making because when the limited time span has passed, treatment is no longer effective and is likely to be more dangerous.
If you have undergone intra-arterial thrombolysis, you definitely need time to recover. Some patients recover completely without experiencing side effects, while others experience mild side effects from a stroke.
