Quickly restoring blood flow to the brain is critical in the event of ischemic stroke, when an obstruction develops in a blood vessel supplying the brain. Both medications and procedures may be used to remove the blockage.
Stopping More Strokes with tPA Treatment
Studies have shown that thrombolytic drugs, or clot-busters, effectively stop ischemic strokes and improve patient outcomes if specialists trained in giving the drugs are immediately available. Ischemic strokes are the most common type of stroke and are caused by blockage of an artery. The most widely known and the only FDA-approved drug for treatment of ischemic stroke — intravenous tPA (tissue plasminogen activator) — can reverse stroke if given to carefully selected patients within a few hours of stroke onset. Neuro-interventional treatments offered at Froedtert hospital can expand the treatment window to 24 hours and beyond in some cases. This means a high percentage of appropriate patients can receive tPA or a procedure to open a blocked blood vessel.
Our stroke team has successfully used tPA since 1996, and actively teach other hospitals how to safely administer this drug. Other new advances in stroke treatment are available, including minimally invasive procedures to restore blood flow to the brain. These procedures may remove clots, prop arteries open (carotid artery stenting) and apply clot-dissolving drugs directly to the blockage (intra-arterial thrombolytic therapy).
Intravenous Tissue Plasminogen Activator (IV tPA)
During the first few hours following an ischemic stroke, intravenous tissue plasminogen activator (IV tPA) and other drugs may be used in select patients to remove or dissolve clots. Around the clock, a team of stroke specialists at Froedtert & the Medical College of Wisconsin is available with extensive experience in rapidly administering tPA. Patient outcome statistics show that we are leaders among Wisconsin hospitals in administering tPA.
Endovascular Treatment and Clot-Removing Devices
If patients arrive at the hospital too late for effective use of IV tPA or if IV tPA is not appropriate for them, physicians may use endovascular surgery procedures or neuro-interventional techniques to remove the clot. Endovascular procedures are those performed from inside the blood vessel.
They involve navigating a small catheter (a hollow plastic tube) through the blood vessels to the location of the blockage. After the catheter is positioned within the blocked artery, tPA can be injected to dissolve the clot. Alternatively, a device can be used to suction the clot (aspiration) or trap the clot and remove it (retrieval). Our involvement in clinical trials at Froedtert & the Medical College of Wisconsin means we bring the latest clot-busting technology and practices to stroke patients.