New stent used at Upstate University Hospital represents a breakthrough in stroke treatment

Posted: Published on May 26th, 2012

This post was added by Dr Simmons

Syracuse, NY -- Tina Fietta was expecting the worst when her 88-year-old mother, Christine Page, was rushed to Upstate University Hospital in late March after suffering a stroke at Fiettas Cazenovia home.

Pages face was drooping, she was paralyzed on one side and could not speak. Doctors at Upstate determined she had had a blood clot blocking one of the major arteries of her brain and severe hardening of the arteries. The deck was stacked against her, Fietta said.

Page became the first patient at Upstate and one of the first in New York state to be treated with a new device just approved by the federal Food and Drug Administration to remove blood clots from stroke patients.

Dr. Eric Deshaies, a neurosurgeon, threaded a catheter through Pages blood vessels to the blockage in the brain artery. He pushed the catheter through the clot, then deployed a mesh-like stent, which he used to grab the clot and remove it. The procedure, which took about 18 minutes, restored blood flow to Pages brain.

The next morning Pages speech was normal and the paralysis had disappeared. She telephoned Fietta at 6:30 a.m. to ask why she was in the hospital. "What happened in that hospital was almost magical, Fietta said.

Deshaies sees the new device, the Solitaire FR Revascularization Device, as a breakthrough in stroke treatment. The device has been successfully used three times so far at Upstate. To be able to completely remove the clot very rapidly is definitely a game changer, Deshaies said.

The most common type of stroke, called an ischemic stroke, occurs when a blood vessel to the brain is blocked by a clot. If the clot is not removed quickly, the patient can die or survive with paralysis and other long-term deficits. Stroke is the fourth leading cause of death in the United States.

Patients are often given a drug, tissue plasminogen activator tPA for short, to dissolve clots. To be effective it must be administered intravenously within about three hours. The clot-busting drug cannot be used by patients taking blood thinner drugs, or with bleeds to the brain and other conditions, Deshaies said.

Since 2004, doctors have had two devices available to mechanically remove clots from those patients or people who are beyond the three-hour window for tPA. One is a cork screw shaped device to remove clots and the other is a vacuum-type device that sucks out clots. The FDA cleared the new Solitaire stent device in March after a study showed it is safer and more effective than the other devices.

The older devices did not always work on patients like Page with hardening of the arteries, Deshaies said. When you have hardening of the arteries, the arteries get twisted, and its usually difficult to get the clots out, even after multiple passes and attempts, Deshaies said.

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New stent used at Upstate University Hospital represents a breakthrough in stroke treatment

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