Akash Kansagra, MD, Washington University neurointerventional surgeon at Barnes-Jewish Hospital, provides an overview of the latest clinical trials for treating stroke patients.
Learn more about stroke research and clinical trials.
Click to read the video transcription
In medicine, there’s a deeply held principle that you only do procedures and interventions when you have a reasonable belief that it’ll help patients. And what that means for us at Barnes-Jewish Hospital, is that we practice based on evidence-based medicine.
There are recently two new trials that came out called DEFUSE 3 and DAWN, that give us that evidence for patients with stroke. So until those trials came out, we only knew that we were helping patients by doing a procedure out to about six hours after the start of symptoms related to stroke.
So these two trials, are really important, because they extend the time window in which we can potentially implement a thrombectomy. What a thrombectomy is, is an interventional procedure where you put a very small catheter through an artery in the leg, work your way up to the brain and physically remove the blood clot that’s causing the symptoms of stroke. These trials make use of something called CT profusion imaging, which is an imaging technique that aims to give us detailed information about whether portions of the brain have already sustained irreversible injury or if they’re potentially salvageable.
And what these trials allow us to do now is to confidently implement treatment in some patients who are well beyond six hours, and in fact, in some cases, out to 24 hours. So these trials give us a foundation on which we can tell patients, look them in the eye and say, your likelihood of improving, getting back to your normal self, is maybe twice as good as if you don’t have that procedure. For patients who are having stroke, that can be a huge difference in the quality of life, and really their potential to lead a normal or near normal life after the procedure.
So I think having these trials in hand will really change how we treat patients with stroke. We know that we have to be tuned into the possible that we might be able to help these patients up to 24 hours instead of just six hours. The difference is pretty astounding in terms of how effective that procedure is.