Headlines Around the Low Country
Imaging Study Shows Stroke Patients Receive Successful Treatment Beyond Four Hour MAGIC WINDOW
Perfusion imaging redefines widely-accepted treatment time frame for stroke
CHARLESTON, SC – September 6, 2012 - Practitioners who treat stroke
patients now have proof that perfusion imaging can better determine who
is and who isn't beyond the "magic window" to restore blood flow to the
brain. Lead study author Aquilla Turk, D.O., MUSC Interventional
Neuroradiology co-director and neurosciences and radiology professor,
described the study as a landmark turn in providing patients with
treatments they may not have had otherwise. Currently, the standard of
care most providers use as a treatment criterion is the four-hour "magic
window."
"This study definitively shows that perfusion imaging as a patient
selection criterion for endovascular therapy is a successful evaluation
tool, whether patients are presenting at three hours out from their
stroke or 11 hours," Turk said. "Broadly speaking, these results could
transform our approach to patient selection and ultimately may mean that
we will be able to treat significantly more patients and reduce the
devastating burden of this disease on individuals and families."
Study results show that patients with ischemic stroke may be
successfully treated with endovascular therapy well beyond the 4.5 hour
treatment window today considered standard by most neurointerventional
practitioners. The multi-center study evaluated the use of computed
tomography (CT) perfusion imaging, regardless of time from symptom
onset, in selecting patients for endovascular treatment, a technique
which utilizes devices or clot-busting drugs directly at the problem
site in the brain to dispel clots and restore blood flow. CT perfusion
imaging is used in combination with other imaging techniques to
determine which areas of the brain are irreversibly injured from a
stroke, and which areas are still alive, but at great risk. From there,
practitioners can better decide who is still a candidate for treatment.
According to Neurosciences clinical chairman and neurosurgery professor
Sunil Patel, M.D., South Carolina had one of the highest mortality rates
from stroke in the country about five years ago. Patel applauded the
strides the department made to recruit and retain some of the nation's
top stroke experts while bringing the infrastructure of the program up
to speed. "Within this short period, we have come to offer unparalleled
stroke care in this state, and now have one of the most comprehensive
stroke programs in the country. South Carolinians are finally seeing
greatly reduced stroke mortality rates and significantly improved
outcomes after treatment," he said.
Study data collected from the Medical University of South Carolina
(MUSC) in Charleston, Swedish Medical Center in Denver, Co., and the
University of Florida in Gainesville, showed that out of 247 patients
for whom perfusion imaging was used, 42.5 percent demonstrated good
functional outcomes, which is comparable to results from all other
significant trials to date which evaluated endovascular therapy
conducted under eight hours. Notably, this latest study showed no
significant difference in treatment outcome between patients treated
less than eight hours (42.8 percent) and those treated over eight hours
(41.9 percent). Additionally, immediately following treatment,
restoration of blood flow was accomplished in 76 percent of patients,
with a higher success rate in those treated over eight hours (81.1
percent) as opposed to those treated under eight hours (71.7 percent). All study subjects underwent mechanical thrombectomy, or treatment
utilizing devices to restore blood flow.
According to the American Stroke Association, approximately 795,000
Americans suffer a new or recurrent stroke annually. Of that total,
137,000 individuals die each year from stroke, making it the fourth
leading cause of death. In 2010, Americans paid approximately $73.7
billion for stroke-related medical costs and disability.
About MUSC
Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 13,000employees, including approximately 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.7 billion. MUSC operates a 750-bedmedical center, which includes a nationally recognized Children's Hospital,the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit www.musc.edu. For more information on hospital patient services, visit www.muschealth.com
