According to a pilot study led by the University of Cincinnati, standard clot-busting medication when used in combination with low-energy ultrasound appears to re-open clogged arteries in stroke patients better than medication alone.
The study by Dr. Joseph Broderick, a neurologist and Dr.Thomas Tomsick, MD, a neuroradiologist, is known as the Interventional Management of Stoke Study or IMS-II.
It involved 73 participants between the ages of 18 and 80 treated in 13 participating centers and suffering from severe ischemic stroke.
Each was given lower than standard doses of tissue plasminogen activator (tPA) during a 30-minute period and within three hours of the onset of stroke.
TPA is a very effective clot-busting drug that can produce a dramatic reversal of stroke symptoms and is used in certain patients having a heart attack or stroke.
It works by dissolving blood clots, which cause most heart attacks and strokes.
Quickly reopening clogged brain arteries in stroke patients is important because the longer the blood supply to the brain is blocked, the more likely long-lasting brain damage will occur.
Although it was approved by the U.S. Food and Drug Administration for treating strokes almost 10 years ago, it is still not given to most stroke victims.
The patients after being given the initial dose of tPA were then immediately taken for an angiograph where a small tube was placed into a groin artery and threaded to the site of the blocked artery in their brain.
Twenty-one participants without a visible and treatable clot received no additional therapy.
The remainder of participants (52) who had visible, treatable clots was treated with up to 22 milligrams of additional tPA delivered through the catheter directly to the blockage.
Whenever possible, they were also given a low-energy ultrasound treatment at the site of the clot to break it up.
In 18 cases where the catheter could not access the clot, a standard catheter was used to deliver tPA to the clot site.
Partial or complete reopening of the blocked brain artery occurred in 69 percent of the 34 patients receiving the ultrasound treatment.
This was an improvement when compared with the IMS-I study, in which 55 percent of patients involved achieved partial or complete reopening of the blocked artery.
The IMS-I study used only a microcatheter to deliver tPA directly to the location of the stroke-causing clot.