Acute Stroke Treatments: Ischemic Stroke
When you or your loved one gets to the hospital, the goal is safe, but fast care…we’re talking about saving your brain here people! In an ischemic stroke (don’t know what that is? check out the post on different stroke types), there are several hyperacute (emergency) treatment options, if you are eligible.
It is important to note that acute stroke treatments can lead to improved outcomes and minimized disability. However, a good outcome is not guaranteed.
Continue reading below for some of the treatments that may be offered for ischemic stroke…
“time is brain, the quicker the treatment, the better the chance of recovery”
Clot Busting Medication
What is it? alteplase or, r-TPA as it’s more commonly known, is approved by the FDA in the treatment of stroke. It is a tissue plasminogen activator, which essentially means it is a medication that works to dissolve blood clots and restore blood flow to the brain (phew!).
How does it work? TPA can sometimes help break down a clot that is blocking blood flow in the brain (which is causing the stroke). If it breaks down the clot, the blocked blood vessel will reopen, allowing the affected area to receive blood flow again. If the clot can be dissolved quickly enough, it is possible for that area of the brain to recover from the stroke and decrease the symptoms, or disability or an ischemic stroke.
If you are determined to be eligible for tPA, your doctor will prescribe the medication in the emergency department, and it will be given over one hour via intravenous route (IV). During this time you will be closely monitored by your treatment staff.
What is it? tenecteplase, or TNK, is a medication that has been studied for over 20 years in myocardial infarction (MI) patients and works in a similar way to TPA. It works to break up blood clots and restore blood flow to a specific area, like the brain. Tenecteplase is also given intravenous, but instead of an infusion of an hour, it can be pushed quickly through the IV.
Which one is right for me? Your treatment team will determine which, if any, “clot busting” drugs can be offered. There is strict criteria on who can and cannot receive these medications. This decision is made with the purpose of minimizing risk of injury from the medication in certain people.
Will a “clot busting drug” return my loved one “back to normal”? Research supports 1 in 3 patients who receive tPA will show some improvement. For every 100 patients, about 33 patients get better, and 3 get worse.
Are there risks with this medication? A risk of a “clot busting” therapy is bleeding in the brain, which can be fatal. Don’t let this scare you! The risk is generally outweighed by the benefits, if treatment is given early enough. That is why the treatment team works so hard to make sure the right patients receive the medication.
Mechanical Thrombectomy
This is a surgical procedure where a specialist will place a catheter in the blocked artery in the brain and remove the clot. This can be done using a “stent retriever device” or suction to reopen a blocked artery and restore blood flow to the injured area of the brain. This is usually performed with strokes that occur in larger arteries. Mechanical thrombectomy can be done up to 24hrs of the “last known well” time, but like the all stroke treatments, time is brain. The quicker the ability to restore blood flow, the better the chance of recovering.