The New York Times carried a story on December 17 about a study in the Netherlands describing a new means of dealing with large brain clots causing a stroke. For a number of years now, tPA has been used to treat ischemic strokes resulting from clots in small vessels, as long as the treatment is given within 3-4 hours after onset of stroke symptoms. tPA is a clot busting drug that can reduce brain damage due to these types of strokes if given within this window. But tPA often did not dissolve clots in the larger vessels in the brain, and those clots often were associated with more disabling stroke symptoms.

The recently described procedure involves the use of a newly designed stent-like device that has a snare at the end to grab the clot and pull it out. The stent is threaded into an artery in the groin and pushed into the brain until it gets to the clot. The study indicated that a significantly larger percentage of patients benefited from this new procedure than those who only received tPA.

Neurologists were enthusiastic about the potential for this new procedure and one called in a “game changer.” Another said: “I think this is the real thing.” Now, larger trials will be started in various stroke centers in the U.S. to see if the results are replicated elsewhere. As with all new medical devices and procedures, doctors need to be trained to use the device effectively, so it may be several years before the new procedure use is wide-spread.