Treatment with Clot-Busting Drug Yields Better Results After Stroke
Baltimore, MD - In an update to previous research, Johns Hopkins neurologists say minimally invasive delivery of the drug tPA directly into potentially lethal blood clots in the brain helped more patients function independently a year after suffering an intracerebral hemorrhage (ICH), a deadly and debilitating form of stroke. Rates of functional recovery with the active tPA treatment far surpassed those achieved with standard “supportive” therapy that essentially gives clots a chance to shrink on their own.
In the Johns Hopkins-led study, ICH patients who randomly received the minimally invasive surgery to deliver a drug designed to dissolve their golf ball-sized clots went home from the hospital an average of 38 days sooner than those receiving supportive therapy. In addition to the health benefits, the tPA therapy, and resulting shortened hospital stay, led to a savings of an estimated $44,000 per patient, the researchers say. ICH has long been considered surgically untreatable under most circumstances; roughly 50 percent of people who have such a stroke die from it.
“This is the most promising treatment that has come along in the last 30 or 40 years for people who have suffered hemorrhagic stroke,” says study leader Daniel F. Hanley, M.D., a professor of neurology at the Johns Hopkins University School of Medicine. Hanley is scheduled to present the study’s findings at the International Stroke Conference in Honolulu, Hawaii, Feb. 6 through Feb. 8.
Evidence for the value of active use of the clot-busting drug emerged from follow-up visits of 96 patients from 25 medical centers, all between the ages 18 to 80. Hanley says he hopes this will lead to a larger study of 500 patients. Hanley says the larger-scale study should provide enough information to determine definitively whether the intervention can transform the practice of caring for brain hemorrhage. The drug tPA (tissue plasminogen activator) has long been used to dissolve clots in the lung and those formed by heart attacks involving major blood vessels. Historically, tPA has not been considered appropriate for hemorrhagic stroke patients. Continue>
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