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13 May 2019

Melbourne researchers have doubled the window of opportunity when clot-clearing treatments can be given to stroke patients.

An international trial using brain scans instead of a clock to detect salvageable brain tissue following a stroke, revealed that anti-clot drugs could be used up to nine hours after most strokes.

This equates to an extra 3,000 stroke patients can be given lifesaving treatment each year.

As reported in the Herald Sun, the research was led by Royal Melbourne Hospital and involved 225 patients whose brain scans indicated they had at risk brain tissue. They were given either placebo or clot-busting medication between 4.5 and 9 hours after a stroke.

Three months later, 35 per cent of stroke victims treated had no or very little symptoms, compared to 25 per cent who had placebos.

In the first 24 hours after treatment, double the number of treated patients had early neurological improvement. Those treated later did just as well as those treated early.

Lead author of the study, which was published in the New England Journal of Medicine, Associate Professor Henry Ma, said the results meant a lifeline was extended to one in five who had a stroke in their sleep and would otherwise not have been able to receive time-dependent medication.

It could also help stroke victims in regional areas who are not close enough to specialist treatment.

“Time is important. You’re losing two million brain cells a minute after stroke,” he said.

“But it’s imaging that matter, not the clock anymore, when deciding who to treat.

Until now, only 15 to 20 per cent of eligible patients with ischaemic stroke receive the intravenous mediation needed within the 4.5-hour time frame.

That can now be doubled.

Receiving the clot-busting medication gets the blood supply back to damaged brain tissue and can open blocked blood vessels.

Getting the treatment within the required time window is crucial and can determine if a stroke patient can recover to the point of leading a relatively normal daily life.

With that window now doubled, researchers are excited at the prospects.

Director of the Melbourne Brain Centre, Professor Steve Davis, who is an author of the study, said the findings will improve the quality of life for many people.

“In strokes, you get this core that dies very quickly, and it expands but can still potentially be resuscitated,” he said.

“In some people, that growth is fast and in some it’s slow. The only way you can tell is by doing that measurement.

“It’s exciting to speculate we could push this out further to 24 hours.”


Published: 13 May 2019