A study has recently suggested that an ‘explosive evolution’ of techniques can restore blood flow to areas of the brain endangered by stroke or clogged arteries. More recently, physicians have begun using minimally invasive endovascular techniques.
Endovascular techniques do not require invasive open surgery. The physician employs catheters (thin tubes) that are guided through blood vessels to the brain. From the tip of the catheter, the physician deploys stents or other devices to restore blood blow.
According to Loyola University Health System researchers, the last 50 to 60 years have witnessed an explosive evolution of techniques geared at restoring blood flow to compromised regions of the brain. Senior author Camilo R. Gomez said, “The chances that a stroke patient will have a good outcome are two to three times better now than they were 10 to 15 years ago.”
They added that these endovascular techniques have amplified the dimensions of care for many patients whose therapeutic options were previously limited. Cerebral vascular insufficiency (not enough blood flow to the brain) increases the risk of stroke and is a major cause of neurologic death and disability worldwide. It is typically caused by atherosclerosis (build-up of fats, cholesterol and other substances that clog arteries that supply blood to the brain).
Techniques and procedures used to improve blood flow to the brain are similar to those used in heart procedures. They include bypass surgery, balloon angioplasty and stenting. One of the latest devices is called a stent retriever (also known as a stentriever). The device is a self-expanding mesh tube attached to a wire. It is guided through blood vessels to a clot that is blocking blood flow to a part of the brain.
The device pushes the blood clot against the wall of the blood vessel, immediately restoring blood flow. The stent retriever then is used to grab the clot, which is pulled out when the physician removes the catheter. Modern endovascular techniques can, in effect, stop a stroke in its tracks by removing blockages. Patients with the largest blockages and most devastating strokes are deriving the greatest benefits, said Joseph C Serrone.
Seven clinical trials have shown that endovascular techniques restore significant function in these patients. Dr Gomez added that other surgical and endovascular procedures described in the paper can prevent strokes by restoring blood flow to chronically blocked vessels.