Wednesday, April 29, 2015

New method for stroke treatment – challenge for the county councils – forskning.se

– The method has amazing effects. The patients’ chances of survival and maintaining quality of life increases significantly, so this is a paradigm shift in healthcare, says Nils Wahlgren, MD and professor at Karolinska Institutet.

There is always a rush at a stroke. Upon timely treatment, the parts of the brain where blood flow is hampered recover, but it is not always successful. At the so-called thrombolysis solve the blood clot with drugs, but with larger clots or when thrombolysis is appropriate for the patient does not treatment.

Further development of the former method
A few years ago a new method called thrombectomy. Then you go into the body by a catheter through the aorta up to the affected part of the brain. In the end set to begin a corkscrew-like device and having it tried to get hold of the plug by screwing through it, and then slowly pull it out.

Now, the instrument developed. Instead of corkscrew strapped a microscopic nets out at the blood clot. When it expands pressed the clot away while stuck in the net. Even when the network is precipitated blood may begin to flow past the plug and then the plug can be safely removed. The result is so good that several studies recently undertaken had to be interrupted. As it was considered unethical to continue treating patients who come in with strokes on the old way when the new gave such good results.

– This will change health care. We are now working on research to identify patients who can be helped with this technology. These are groups with significant blood clot, but where opportunities to fix the stroke before it went too far left, says Professor Wahlgren.

Equal treatment possible?
Since there is always a rush at a stroke raises method questions about how it is possible to offer equal care. Today the equipment of a modern thrombectomy not at all hospitals and it means that patients can be helped by a thrombectomy in many cases must be moved to a big city. Here comes the National Board work on guidelines for the care set.

– We are on the ball. Thrombectomy is part of the investigative work on guidelines for stroke that we will be finished in 2-3 years, says Sofia Orrskog, project manager at the National Board.

The National Board must map the studies are made and then set priorities between different actions before they can formulate recommendations. These recommendations will then form the basis for a common method for evaluating a patient.

– If it is so that there will be thrombectomy in all hospitals so it is important to have procedures for how to send those patients who do not live near the hospitals that perform abortions. There is no obvious answer to the question today, but this is something that must be discussed thoroughly in health care and that we will take up in our judgments, says Sofia Orrskog.

Description: Day Kättström, freelance journalist on behalf of forskning.se

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