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Advanced Treatments
Penumbra Clot Retrieval Device
Penumbra: New Treatment Option for Stroke
| Froedtert & The Medical College of Wisconsin were among 35 healthcare sites in the United States — and the only site in Wisconsin — to participate in a clinical trial of Penumbra, a device to remove large blood clots in the brain. Following the study, which began in 2006 and involved a total of 125 patients, Penumbra was approved by the U.S. Food and Drug Administration in January 2008. |
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With five patients, Froedtert & The Medical College of Wisconsin were among the top 10 enrollment sites in the country for the Penumbra trial.
About PenumbraPenumbra is a treatment option for people who have suffered a moderate to severe ischemic stroke (a stroke that occurs as a result of an obstruction in a blood vessel). Penumbra may be used when treatment with tissue plasminogen activator, or tPA (an intravenous clot-busting drug), is not recommended or in conjunction with tPA to achieve a higher efficacy. Penumbra can be used up to eight hours from the onset of stroke symptoms. The use of Penumbra also depends on the size and accessibility of the clot and the initial severity of the stroke.
First, a blood clot is located using cerebral angiography (brain catheterization) to image the blood vessels of the brain and the blood flowing through them. Cerebral angiography involves passing a catheter into a large artery in the groin and advancing the catheter up through the carotid artery that leads to the brain under X-ray guidance and monitors. A dye (contrast agent) is then injected into the carotid arteries, and X-ray is used to image the dye flowing through the blood vessels.
If a large clot is found, Penumbra may be used to try to remove part or all of the clot. The device is delivered into the brain through the catheter and moved through the blood vessels to the site of the clot. A “separator” is advanced through the catheter and then retracted to dislodge the clot. A suction device then grasps the clot for removal.
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The Penumbra clot separator, available in various sizes (left), is advanced in and out of the clot to disrupt it. The clot separator is housed in a suctioning microcatheter, and a suctioning machine (right) is attached to the microcatheter. (Click on each photo to see the larger picture in a new browser window)
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Expert StaffThree Medical College of Wisconsin physicians in the Department of Neurology and Neurosurgery are certified to use Penumbra:
Brian-Fred Fitzsimmons, MD
John R. Lynch, MD, FAHA
Sam O. Zaidat, MD, MSc
These fellowship-trained physicians have expertise in endovascular (inside the blood vessels) interventional radiology and the endovascular treatment of neurovascular disorders.
Dr. Zaidat will present data from the Penumbra study at the 60th annual meeting of the American Academy of Neurology in Chicago, April 12-19, 2008.
Study ResultsThe national study of Penumbra, which involved 125 patients, showed that it was successful in some clot removal in 82 percent of cases. In 40 percent to 60 percent of cases, Penumbra was successful in completely removing the clot. (This compares to a 20 percent to 40 percent success rate of complete clot removal with other methods.) One-third of patients experienced complete clinical success and were able to return to their normal activities without any deficits.
Froedtert & The Medical College of Wisconsin remain the only healthcare facility in Wisconsin to offer Penumbra as a treatment option for patients who have suffered an ischemic stroke.
Author: Marla Fraunfelder Date: Feb. 19, 2008 | Medical Reviewer: | Sam Zaidat, MD, MSc |
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