• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Two Clot Busters Boost Stroke Recovery

Posted on: Tuesday, 27 May 2003, 06:00 CDT

By Serena Gordon, HealthScoutNews Reporter

HealthScoutNews -- When doctors began treating strokes with the clot-busting drug tissue plasminogen activator (tPA), survival and recovery rates jumped, but not all patients respond well to the therapy.

That may be because blood clots re-develop in as many as one in five patients after initial treatment with the clot-dissolving medication, says a new South Korean study.

In a report appearing in the May 27 issue of Neurology, researchers from Yonsei University in Seoul found that in 22 percent of the stroke patients studied, clots formed again as soon as 20 minutes after the arteries had been cleared by tPA. But when the researchers added another blood-thinning medication, abciximab, to the treatment, the new clots were dissolved.

"Reappearance of blood clots after initial successful treatment occurred frequently," says the study author Dr. Ji Hoe Heo, an associate professor of neurology at Yonsei University. "This study is promising because simple but careful observation for occurrence of reappearance of clots may improve the rate significantly by giving abciximab in those patients."

Abciximab works specifically on the platelets in the blood. Platelets are the blood cells that cause clots to form, normally to stop bleeding.

Stroke is the third leading cause of death in the United States, killing more than 700,000 people every year, according to the American Stroke Association.

For this study, the researchers studied 18 stroke patients who were treated with tPA. Standard treatment in the United States is to give tPA through an intravenous line, but for this study, the researchers administered the drugs through a catheter placed in the artery.

Dr. Keith Siller, director of the Comprehensive Stroke Care Center at New York University Medical Center, says administering the drugs this way may lessen the chance for side effects, but more importantly it lets the treating physician see exactly what is going on. He says it's similar to the way cardiologists break up blockages in coronary arteries.

The drawback to this method, especially when treating arteries in the brain, is the risk of causing bleeding. Plus, it is only done in specialized hospitals, not in most community hospitals.

The researchers found that in four of the patients treated with tPA, clots formed again soon after the original clot was dissolved. They treated these patients with abciximab through the arterial catheter.

Two of the patients had no symptoms after the second treatment and one only had minor symptoms. These three were able to return to their previous activities and jobs. The fourth patient had a slight hemorrhage that the researchers didn't believe was caused by the treatment.

Heo says that none of the patients suffered any serious side effects in this study, but adds that any type of clot-busting drug carries the risk of unwanted bleeding.

Siller says this study shows why tPA doesn't work for all patients. "Stroke is a very complicated event. It's not just a simple clot. It can change as you start treatment," he says.

That's why "controlling risk factors will always be more effective than treating a stroke," he says. And, he adds, most patients don't come in early enough for any of these treatments to be effective. If you have any of the following symptoms, call 911 right away:

-- Sudden numbness or weakness of the face, arm or leg, especially if it's one-sided;

-- Sudden confusion or trouble speaking or understanding;

-- Sudden vision problems;

-- Sudden dizziness, loss of balance or coordination;

-- Sudden trouble walking;

-- Or sudden and severe headache with no known cause.

Finally, Siller points out this study was very small and no definitive conclusions can be drawn from it yet.

-----

On the Net:

American Stroke Association

National Institute on Aging

Yonsei University

Comprehensive Stroke Care Center

More science, space, and technology from RedNova

Copyright © 2003 HealthScoutNews. All rights reserved. The information contained above is intended for general reference purposes only. It is not a substitute for professional medical advice or a medical exam. Always seek the advice of your physician or other qualified health professional before starting any new treatment. Medical information changes rapidly and while Yahoo and its content providers make efforts to update the content on the site, some information may be out of date. No health information on Yahoo, including information about herbal therapies and other dietary supplements, is regulated or evaluated by the Food and Drug Administration and therefore the information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor.

More News in this Category