This Clot-Busting Drug Increases Survival Chances From Hemorrhagic Stroke
Two new studies suggest that a clot-busting drug used for heart attacks and non-bleeding strokes has the potential to decrease the death rate among patients with hemorrhagic stroke.
Researchers learned that the powerful clot-busting drug, popularly known as tissue plasminogen activator (tPA) might help patients with hemorrhagic (bleeding) stroke.
Two new studies were presented on Thursday at the stroke association's annual meeting in Los Angeles suggest that tPA has a role to play in treating bleeding stroke.
First Study: tPA Vs Saline
The first study involved 500 patients with intraventricular hemorrhage. They treat these patients with either tPA or saline through a brain catheter.
They followed the patients for five years after their treatment from 2009 to 2015. The scientists learned that the death rates among patients who received tPA decreased by 10 percent. They were also one-third lower than the casualty rate in the saline group.
Eighteen percent with larger clots -- greater than 20 ml of pooled blood who received tPA had positive results than those who took saline. Moreover, 79.8 percent of patients given with tPA had 80 percent clot removal and 90 percent of them had more than double their chance of survival.
"When we entered into the trial, we knew very little about how this therapy ought to be used, in whom it should be used, and whether it was safe," said Dr. Issam Awad, a professor of surgery at the University of Chicago in a press release. "We now have clear data on how best to implement the procedure, and for at least a group of patients, we know it can nearly double the likelihood of a favorable outcome."
Second Study: Directing tPA to Brain
Researchers led by Dr. Daniel Hanley, who is from Johns Hopkins University in Baltimore, learned that directing tPA at the brain's ventricles -- fluid-filled cavities decrease the death rate from bleeding stroke by 10 percent.
tPA cleared the blood that pooled in the brains of people with intraventricular hemorrhage. This technique has a good safety profile with similar or even lower rates of brain infections or serious side effects compared to standard treatment, Hanley's team reported.
tPA For Bleeding Stroke
Initially, many believed that using tPA to treat bleeding stroke is counterproductive. However, the results of the two studies showed otherwise.
"Contrary to belief, infusion of clot-buster drugs into the brain improved outcomes in patients with a brain bleed -- this is counterintuitive, as one would not think that infusing a clot-buster drug would be appropriate and safe," said Dr. Paul Wright, chair of neurology at North Shore University Hospital in Manhasset, N.Y.
The experts note that the results of the two studies have not yet been published in a per-reviewed journal and until then it is considered preliminary.
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