14 DAY TRIAL // This will leave your brain clean, but not washed! A "vacuum cleaner" for the brain could fix the clogged arteries of stroke victims, preventing the attack from having permanent serious consequences.
Strokes usually take place when blood vessels nurturing the brain are blocked, and the oxygen-demanding neurons die. The clot-dissolving drug, TPA, can make the difference between permanent brain injury or recovery, if injected intravenously within three hours from the first symptoms. But less than 5% of stroke victims receive TPA, as they do not reach at the hospital in time. And of those receiving TPA and treated, just around 30% benefit of it, as the clot is in most cases too big or tough for TPA to work effectively.
But Penumbra (this how the device is named) can be tried up to eight hours after a stroke has installed, or if TPA fails. A tiny tube is threaded inside a blood vessel at the groin and is pushed up the body into the brain until getting to the clog, where (like a vacuum cleaner) it sucks up the clot piece by piece, removing it, as described in the research to be presented at the annual meeting of the American Stroke Association.
"For the right patient, Penumbra can produce dramatic help," said Dr. Demetrius Lopes of Chicago's Rush University Medical Centre, one of the 24 hospitals that checked the device in 125 severe stroke patients.
In the case a 45-year-old female stroke patient, due to a blocked key artery, and whose left side remained paralyzed about an hour following a large TPA dose, Penumbra helped her, as she was walking the next day, with only a weakness (not paralysis) in her left arm.
In December 2007, Penumbra received the approval from the Food and Drug Administration.
"It causes few serious side effects, and about 42% of successfully treated patients showed significant recovery a month later," said Lopes.
Another tested anti-stroke device is a corkscrew-shaped wire, Merci Retriever, which would go through the clot and tug it out. Other trials investigate dripping TPA directly on the clot instead, or even to attack the clog with ultrasounds.
But "unclogging sometimes does more harm than good in bad strokes. When the dam is broken and blood rushes into oxygen-deprived brain tissue, it sometimes triggers swelling or a brain hemorrhage. Either can kill," said Dr. Walter Koroshetz of the U.S. National Institutes of Health for Neurological Disorders and Stroke.
"So treatment is a balancing act: Using brain scans to estimate if the stroke already has killed all the brain tissue it is going to, or if enough still could be salvaged that it's worth the risk of this injury. Your ability to succeed with taking the clot out depends on what's going on in the brain," said Koroshetz.