Offering the Latest Innovations in
Stroke Treatment
Endovascular
rescue therapy, also known as neurointerventional therapy, is a relatively new treatment available for eligible patients experiencing
acute ischemic stroke – a stroke caused by
a blood clot in the brain. The treatment involves placing a catheter into the
brain and removing the clot that’s causing the stroke.
Endovascular
therapy must be done within six to eight hours of the onset of a stroke,
depending on the location. Endovascular treatment can restore blood flow within
minutes.
Studies
show that patients who receive endovascular rescue therapy after intravenous
tissue plasminogen activator (IV tPA) have better outcomes than patients
treated with medical therapy alone.
Evaluation
Not all
patients experiencing ischemic stroke are eligible for endovascular therapy. It
is considered only in patients who:
- Are at least 18 years old
- Score 6 or higher on the National Institutes of Health Stroke Scale (NIHSS)
- Have received IV tPA within 4.5 hours of the onset of symptoms
- Have a proven large arterial blockage on imaging
- Are eligible to receive endovascular therapy within 6 to 8 hours of the
onset of stroke symptoms, depending on location
Treatment With Endovascular Rescue
Therapy
Most
hospitals can apply IV tPA to begin breaking down the blood clot that’s causing
the ischemic stroke. Once a patient is stabilized, he or she can be transferred
to a higher-level stroke center such as UT Southwestern for endovascular rescue
therapy.
If a
patient qualifies for endovascular rescue therapy, a neurosurgeon or
neurointerventional radiologist will begin endovascular therapy as soon as
possible. The physician will thread a thin wire tube with a wire mesh (called a
stent retriever) at its end through an artery in the patient’s groin and use X-ray
and contrast dye to guide the tube up into the brain until it reaches the
blocked vessel. Once the tube is pushed into the clot, the physician expands
the stent retriever to grab the clot, which is removed as the tube is pulled
out.
The
procedure takes about 2 hours. After surgery, patients receive care in UT
Southwestern’s dedicated neuro intensive care unit (neuro ICU).