SNF Brain Stroke Samachar-441

[SN Foundation]

Overlake
 testing
 device to remove clots
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Hospital one of three sites nationally to test benefit for victims of
strokes
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COURTESY: UNIVERSITY OF WASHINGTON NEWS LAB, JUNE 10, 2013
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A grain of rice. That is approximately the size of a stroke victim’s
blood clot.

Overlake Medical Hospital is one of three hospitals in the U.S.
participating in a FDA trial testing the Separator 3D, a new device to
remove ischemic blood clots with less invasive methods.

Dr. Abhineet Chowdhary, director of neurosurgery at Overlake, will be
one of the primary doctors handling the device.
“This particular [device] incorporates a lot of the good function of
what’s already out there, but combines it into one,” Chowdhary said.
“It’s like saying the wheel is good, an engine is good, AC is good,
let’s make a car. You don’t want each one of those pieces, but you
want the car.”

This device treats only ischemic stroke, an obstruction caused by a
blockage in the brain. Veins closer to the brain are smaller compared
to veins in the body. As people get older, blood vessels narrow,
increasing the risk.

According to the National Stroke Association, stroke is the fourth
leading cause of death in the United States, with over 133,000 deaths
per year out of approximately 795,000 strokes that occur. Ischemic
strokes account for 87 percent of all strokes.
Controllable risk factors for stroke are similar to risk factors for
heart disease and cancer, such as smoking, high cholesterol, high
blood pressure and living a sedentary lifestyle.

Current methods for treating stroke are an IV tPA-a drug with clot
busting properties, administered through an IV-and mechanical
thrombectomy, a process done by machines similar to the Separator 3D.
The device is made of a malleable material called nickel titanium
alloy, or nitinol, and is soft enough to not damage blood vessels.
Inside the sheath, which is a tube, the device is attached to a green
wire used to control it.

A different tube is connected to the suction device and to the
patient. The device is inserted into tubes already in the patient. The
size of tubing becomes progressively smaller in circumference to fit
within the increasing smaller vein size closer to the head.
Once the end of the device’s sheath has reached past the blood clot,
the device is deployed out of the sheath and opens up slowly, trapping
the blood clot into its pockets. After waiting for the clot to stick
in the device, the doctor would turn on the suction device and the
blood is sucked out.

This allows blood flow to return quicker than traditional devices
because of the use of a stent, a scaffolding to open up the clot,
resulting in oxygen reaching the brain sooner.

“We always want to improve our safety and make safety the prime
concern,” Chowdhary said. “If we can also improve the outcome by
getting the blood clot out, fantastic. This stuff allows us to do
that, which is great.”

Data gathered from all three locations are sent to one central
location and monitored as the results come in, per FDA safety
regulations. The trial has started and could last one to two years
depending on the results.
If a stroke patient chooses to enter the trial, he or she will be
randomly selected for traditional treatment or treatment by the
Separator 3D. Each treatment will be administered to half of the
patients.

Even with medical advancements, Chowdhary said increasing public
awareness is the best thing for stroke care. Many people don’t
actually believe a stroke is an emergency, he said, and hence don’t
seek immediate care.

“Time is brain,” Chowdhary said. “The more time you spend not coming
into the hospital, the more brain that is lost.”

He prefers to call it a “brain attack” in order for people to take it
more seriously and not delay getting treated.

“To stay on the cutting edge you have to do clinical trials,”
Chowdhary said. “We have been a world class hospital and this is some
of the stuff we’re doing to stay on the cutting edge.”

(Chris Lopaze is a student in the University of Washington Department
of Communication News Laboratory).