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Treatments for Stroke

The Stroke & Neuroscience Program at St. Joseph’s Hospital offers the most up-to-date, technologically advanced stroke treatments available. These include the use of extraordinarily powerful drugs to destroy blood clots, intracranial angioplasty, and noninvasive analysis of patient's blockage and blood flow via the NOVA procedure.

tPA Treatment

tPA is a cutting-edge medical treatment whereby a neurointerventionalist uses a mico-catheter no wider than a hair follicle to insert an anti-thromboltic drug (called "tPA") directly into a blood clot. The drug dissolves the clot.

Because the anti-thromboltic drug is highly targeted to the clot, the dosage to the clot is 100 times stronger than that received with conventional intravenous therapy. But, again because of the highly-targeted nature of the drug, only two percent of the standard dosage of medication is needed.

While this treatment is highly effective, it must be instituted within 3 to 6 hours of the first appearance of symptoms. This is one of the reasons why it is so vitally important that you recognize the symptoms of stroke, and call 9-1-1 immediately upon their onset.

Is follow-up treatment needed?
Three to six months after the procedure, your physician may decide to perform an intracranial angioplasty at the site of the clot. Often, these physicians will leave a permanent stent in place to prevent the vessel from narrowing again.

Intracranial Angioplasty

An intracranial angioplasty is used for people who have suffered a stroke due to decreased blood flow to the brain. Remember, these types of strokes are often caused by a buildup of plaque in the arteries supplying blood to the brain. (The technical term for this condition is intracranial atherosclerosis.) An angioplasty is a procedure through which physicians at St. Joseph’s Hospital's Stroke & Neuroscience Program reconstruct the damaged blood vessels, either by surgery or through the use of a stent – a device used to hold arteries open so that blood flow is increased.

When is angioplasty recommended?
Physicians will generally recommend an angioplasty after reviewing the results of an angiography – a type of brain X-ray. This test can determine whether a patient has suffered an ischemic stroke – or one caused by a decrease in blood flow to the brain.

Who performs an angioplasty?
Vascular surgeons or interventional neuroradiologists usually perform the angioplasty.

How long must I stay in the hospital after an angioplasty?
Most patients can leave the hospital the afternoon after the procedure.

What precautions must I follow after an angioplasty?
For a month after the procedure, patients are placed on a medication called ticlopidine. This drug keeps the platelets in your blood from clotting. In addition, it is suggested that patients take 325 milligrams of aspirin daily for the rest of their lives.

Will the blockage ever recur?
Unfortunately, sometimes the blockages do come back. This is a condition known as restenosis. No drug had been shown to conclusively prevent restenosis. However, antioxidants (such as Vitamins C and E) have shown promise in preventing additional blockages. Also, a medication called probucol (used to lower cholesterol) seems to be beneficial.

What tests are done to check for blockage or recurrence?
If restenosis is going to occur, it will probably appear in the first 6 months after angioplasty. Physicians must keep a close watch on you doing this period. Follow-up tests, including angiograms, should be completed during the year following angioplasty.

What is the outcome of angioplasties?
Although there is always the possibility of restenosis, the outcome for patients having an angioplasty is good.

Are there any risks associated with angioplasty?
As with any surgery, angioplasty does carry potential risks. Here, the artery itself can be damaged, or plaque can be discharged and create a blood clot.

 



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