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Lives could be saved with access to clot-buster device: expert


A close-up of the new device used to remove blood clots.

A close-up of the new device used to remove blood clots. Photo: Supplied

Expanding access to a revolutionary stroke treatment device that has improved the quality of life of survivors would mean many more would be able to live independently again, a medical expert says.

The device, known as a “stent retriever”, looks like a tiny chicken-wire cage.

And it has been shown to double a major stroke patient’s chance of survival and increase their prospects of living independently again from 39 per cent to 72 per cent when combined with an existing clot-busting drug.

Presenting a Melbourne-led study on the device, Auckland stroke neurologist Alan Barber said it was “the most significant advance in stroke care in the last 20 years”.

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“It costs Australia billions. But for every five people you treat with clot retrieval, one more will go home able to function as an independent person, and there is one less person who is left severely dependent,” Professor Barber said, speaking before he addressed the Australian and New Zealand College of Anaesthetists annual meeting in Auckland on Sunday.

But the technique is resource intensive and must be performed soon after the stroke. It requires specially trained radiographers, stroke doctors and anaesthetists to be ready to operate within six hours.

Professor Barber said that, in Victoria, only the Royal Melbourne Hospital could perform the procedure around the clock, although Monash was expected to have the same capability by the end of the year.

“It’s all well and good if you live in Parkville but this treatment needs to be provided equitably to everybody and it can’t be provided at every single hospital, it’s just not possible, there aren’t people to do it and it’s too expensive.”

Professor Barber said doctors at regional hospitals needed to be trained to administer the traditional clot-busting drug, Alteplase, to the patient and then be able to get them on a plane to the Royal Melbourne Hospital within six hours to give patients their best chance at recovery.

“Definitely a lot more lives would be saved and it’s not just saving lives, it’s preventing people from being permanently disabled,” he said.

A CT scan image shows the blood clot (red dot) and the area of the brain that has lost blood supply and is at risk of dying (green)

A CT scan image shows the blood clot (red dot) and the area of the brain that has lost blood supply and is at risk of dying (green). Photo: NCH News

Affecting more than 400,000 Australians a year, stroke is one of the top five causes of death and major disability.

Doctors have been trialling manual ways of removing clots from arteries for a decade but until they started trialling the retriever in 2011, attempts had failed or had been shown to add more risk.

With the new cage-like device they trap the clot by inserting a tube – the size of a headphone cord – into a major artery through the groin then feed it up to the neck and into the brain. 

They pump dye through the tube as it makes its way up, which – with an X-ray – reveals the location of the clot. They can then feed the cage up through the same cord, trap the clot within it and pull it out.

“It’s not rocket science,” Professor Barber said.  “If you don’t open the artery, you don’t turn the hose back on, the brain downstream will die.”

The journalist attended the conference as a guest of ANZCA.



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