After a stroke, doctors may try to remove the clots from the blood vessels to prevent blood from flowing freely to the brain. But while most of these procedures are successful, less than half of people have a successful stroke recovery. A new study published on June 23, 2021, online issue of Neurology, the medical journal of the American Academy of Neurology, sheds light on why this may be.
The study found that trying to recover more than once during a procedure during a procedure blood clot was associated with more disability three months after the stroke than trying to remove a clot once, even when trying to restore blood flow they were successful.
“These findings highlight the need for a study to determine the appropriate strategy to use when the first attempt to recover a blood clot is unsuccessful, as each additional attempt reduced the chances of a favorable outcome.” , said study author Wagih Ben Hassen, MD, of the French National Institute for Health and Medical Research in Paris.
The study included 419 people who had it ischemic stroke, which is the type caused by blood clots. All had endovascular treatments to remove clots using a suction method that uses suction or a stent method that captures the clot, or both methods. All files blood vessels have successfully been removed from clots. But clearing the clots involved an attempt of 224 people, two attempts of 107 people, three attempts of 49 people and four or more attempts of 39 people.
The researchers then examined whether people developed blood clots in new areas, possibly because the initial clot broke into pieces during the procedure which then joined new areas and the growth in the amount of brain damage took about 24 hours. after stroke. They also examined the level of disability of people three months after the stroke.
Overall, 23 people developed clots in new areas 24 hours after the stroke. Of these, two made an attempt to recover the clot, three made two attempts, seven made three attempts, and 11 had four or more attempts.
For the growth in the amount of brain damage 24 hours after stroke, the overall rate was 14 milliliters. For those with a withdrawal attempt, the mean rate was 10 ml, for two 16 ml trials, three 21 ml trials, and four or more 25 ml trials.
Three months after the stroke, people with more attempts to recover clots were less likely to have no disability or mild disability than people with a single attempt. Overall, 57% had no mild or no disability. Of those with an attempt at recovery, 62% had no or mild disability, compared with 55% of people with two attempts, 49% of people with three tests, and 42% of those with three attempts. people with four or more tests.
For all of these measures, the results were still significant after researchers adjusted for other factors that could affect people’s recovery, such as age and severity of stroke.
“Successfully achieving the removal of blood clots and cleansing those blood vessels with the least number of attempts, and ideally with a single pass, seems to be the new goal,” Ben Hassen said. “This underscores the need to develop a new generation of devices designed to increase the overall success rate on the first try.”
One limitation of the study is that while the researchers adjusted for other factors that could affect the growth of the amount of brain damage 24 hours after the stroke, the small number of people in some groupings could affect this analysis.
American Academy of Neurology
Citation: After a stroke, more than one attempt to remove blood clots may be related to a worse outcome (2021, June 23) recovered on June 23, 2021 at https://medicalxpress.com/news / 2021-06-blood-clots-tied-worse -outcome.html
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