News - Hypertension Week of January 4, 2004, Vol. 3 No. 01

Study: Delivering Clot-Busting Drugs Through Arteries Produces Better Stroke Outcomes

Giving clot-busting drugs through the arteries rather than the veins may improve the chances of a good outcome in stroke patients who receive prompt treatment, according to a study reported in the January issue of Neurosurgery.

Ohio State University researcher Eric Bourekas and his colleagues analyzed the results of treating strokes through the arteries in 36 patients treated within three hours after the first symptoms.

Providing clot-busting drugs through the arteries improved flow in the blocked blood vessel in 75 percent of patients. In 39 percent, flow was restored completely. These rates were nearly twice as high as past studies had reported that involved patients receiving such drugs through the standard intravenous route.

One to three months after such treatment, 50 percent of the patients treated through the arteries had little or no disability resulting from their stroke, compared to a 39 percent rate for patients in a landmark National Institute of Neurological Disorders and Stroke (NINDS) study of early intravenous clot-busting therapy.

The risk of bleeding problems was 11 percent for patients treated through the arteries or slightly higher than in the NINDS study. The risk of death in patients receiving intra-arterial therapy was 22 percent, similar to that with intravenous therapy.

The researchers said their findings suggest that providing clot-busting drugs through the arteries improves the chances of disability-free outcomes in patients with stroke.

This probably reflects the higher success rate in reopening the blocked artery, achieved by delivering a higher concentration of the clot-dissolving drug directly to the area of blockage, according to the researchers.

Dr. Bourekas and colleagues called for more research to compare the results of intravenous versus intra-arterial clot-busting therapy. However, because the latter is more invasive, they emphasize that it should only be performed at hospitals with specialized stroke teams available around the clock.

Other sources: Neurosurgery 54: 3, 2004