Stroke treatment:

A stroke is an interruption of the blood
supply to any part of the brain. A
stroke is sometimes called a "brain
attack."


FDA APPROVES COVIDIEN'S
SOLITAIRE DEVICE
In March 2012 Covidien  announced
that the Solitaire FR revascularization
device has been approved by the U.S.
Food and Drug Administration. The
Solitaire FR device is intended to
restore blood flow to the brain in
patients suffering acute ischemic
stroke by mechanically removing blood
clots from blocked vessels.

The approval  was based on the
results of the SWIFT clinical study.The
study compared  two devices.The
Solitaire FR device demonstrated
superior performance compared to the
Concentric Medical Merci Retriever
device, a commercially available
mechanical clot retriever.

The study randomly assigned 113
stroke patients at 18 hospitals to a
procedure to restore blood flow to the
brain with either the Solitaire FR
device or the Merci Retriever device
within eight hours of stroke onset. The
Solitaire FR device showed a 2.5x
benefit in restoring blood flow to the
brain, as determined by a blinded core
lab, a 1.7x improvement in post-stroke
neurological function and a 55%
reduction in mortality at 90 days.

"This new device heralds a new era in
acute stroke care," said Dr. Jeffrey L.
Saver, the SWIFT study's principal
investigator and a professor of
neurology at the David Geffen School
of Medicine at UCLA. "We are going
from our first generation of clot-
removing procedures, which were only
moderately good in reopening target
arteries, to now having a highly
effective tool. This really is a game-
changing result."

Stroke is a disease that affects the
arteries leading to and within the brain.
Ischemic stroke occurs when a blood
vessel that carries oxygen and
nutrients to the brain is blocked by a
clot. According to the American Heart
Association, stroke is the fourth
leading cause of death in the U.S. and
a leading cause of long-term disability.

This is good news for the
approximately 700,000 people each
year in the U.S. who suffer an acute
ischemic stroke.  

The Solitaire FR device received CE
Mark approval in Europe and has been
commercialized internationally by
Covidien since November 2009. The
Solitaire FR device will be available in
the U.S. from April 2012.

The Mansfield, Mass.-based medical
products conglomerate acquired
Solitaire as part of its $2.6 billion
purchase of ev3 Inc. in 2010.

In a separate news Stryker Corp.
acquired rival stroke device maker
Concentric in an all-cash $135 million
deal in September 2011.





HIGH FAT CONTENT, NOT
CHOLESTEROL TO BLAME FOR
STROKE
A 33-year-long study by researchers in
Denmark have for the first time shown
that increased levels of non-fasting
triglycerides are associated with an
increased risk of ischemic stroke in
both men and women.

Higher cholesterol levels were
associated with greater stroke risk in
men only, and that too if their LDL was
double of what it should be. Current
guidelines on stroke prevention have
recommendations on desirable
cholesterol levels, but not on non-
fasting triglycerides.

The study's lead author Dr Marianne
Benn of Copenhagen University
hospital said, "Our study was the first
to examine how the risk of stroke for
very high levels of non-fasting
triglycerides compared with very high
cholesterol levels in the general
population. Our findings suggest that
levels of non-fasting triglycerides
should be included in stroke
prevention guidelines which currently
focus on total cholesterol and LDL
cholesterol levels."

Triglycerides in plasma are derived
from fats eaten in foods or made in the
body from other energy sources like
carbohydrates. Calories ingested in a
meal and not used immediately by
tissues are converted to triglycerides
and transported to fat cells to be
stored. Hormones regulate the release
of triglycerides from fat tissue so they
meet the body's needs for energy
between meals.



STEM CELLS INJECTED INTO THE
BRAIN OF A STROKE PATIENT
Doctors in Scotland  have injected
stem cells into a man's brain as part of
the world's first clinical trial of the cells
in stroke patients.

The former truck driver, who is in his
60s, was severely disabled by a stroke
18 months ago and requires
continuous care from his wife.

Doctors injected around two million
cells into a healthy region of his brain
called the putamen, close to where
neurons were damaged by the stroke.
They hope the injected cells will
release chemicals that stimulate new
brain cells and blood vessels to grow,
while healing scar tissue and reducing
inflammation.

ReNeuron (UK) developed the
procedure. The trial is known as the
Pilot Investigation of Stem Cells in
Stroke (PISCES).



SURGEONS IMPLANTED STENT
INSIDE THE SKULL OF A 14 YEAR
OLD BOY
Neurosurgeons at the University at
Buffalo successfully implanted a stent
in an artery inside the skull of a 14-
year-old boy to prevent a stroke. This  
procedure thought to be the first
conducted in an adolescent.

The boy was home within one day and
remained well at his nine-month
evaluation.



STUDY TO FIND  STROKE
PREVENTION FACTORS
The results are from the
INTERSTROKE study, a large,
multicenter, case-control study that
included patients from low- and middle-
income countries, published online  in
The Lancet (UK).

Total cholesterol was only associated
with an increased risk of hemorrhagic
stroke. Having more HDL, or "good"
cholesterol, appeared to be protective
against ischemic stroke, but not
against hemorrhagic stroke.

More importantly, the ratio of
apolipoproteins B to A1 was
associated with an 89% increase in
stroke risk (95% CI 82.3 to 92.2).

A good diet along with regular physical
activity and moderate alcohol intake
were protective against stroke.

Fruits and fish were especially
protective  but vegetables were not.
The researchers said this relationship
needs further exploration.

Eating more red meat, organ meats, or
eggs came with a 35% increased risk
of stroke, more fried foods, pizza, or
salty snacks carried a 16% increased
risk, and cooking with lard made stroke
risk rocket to 66%.

Exercising was associated with more
than a 30% reduction in stroke risk.

While moderate alcohol intake was
protective, having more than 30 drinks
per month carried about a 50% higher
stroke risk.

Just five of these risk factors account
for more than 80% of the overall risk of
stroke: hypertension, smoking,
abdominal obesity, diet, and physical
activity.



STROKE EMERGENCY TREATMENT
  • Pumping ice slurry into
    bloodstream cools in 5 minutes
    using Argonne equipment;

  • Cooling hood for brain by KCI;

  • spray thru nose to cool brain
    Rhinochill by Benechill;

  • cooling helmet;

  • The liquid perfluorocarbon;

  • MERCI Retriever a corkcrew like
    catheter to pull bloodclot made
    by Concentric Medical;

  • SonoLysis therapy developed by
    ImaRx Therapeutics clotbusting
    ultrasound;

  • Transcranial laser therapy for
    the treatment of acute ischemic
    stroke by PhotoThera Inc;