Stroke victims recover much better after temporary stent procedure

Oregon Stroke Center at OHSU enrolls 35 patients in nationwide trial, most of any study site; director says new procedure will be 'game changer'

A new way of opening blocked arteries in the brain using a removable stent system in people suffering strokes brought remarkably positive results in how those patients recovered from the strokes, according to a study presented this morning at the American Stroke Association’s annual conference in New Orleans.

The interventional procedure was performed on more than 140 stroke patients at 18 medical centers throughout the United States. Stroke specialists at Oregon Health & Science University treated the most patients of any medical center in the country, performing the procedure on 35 patients who were part of the trial.

“I really think this is going to be a game changer,” said Wayne Clark, M.D., a co-author of the study and director of the Oregon Stroke Center at OHSU. “These results showed that not only could we open up the blood vessel but we can help many more people recover fully from their strokes when this ‘stent retriever’ procedure is used.”

Clark was part of the OHSU stroke team that performed the procedures, which also included specialized neuro-interventionalists led by Stanley Barnwell, M.D., Ph.D., an associate professor of neurological surgery and diagnostic radiology at OHSU.

The procedure was performed on patients who were within eight hours of suffering an "acute ischemic stroke" — a medium to large stroke caused by a lack of blood flow to the brain, often caused by a blood clot. During the procedure, stroke doctors use a catheter to guide the small stent from the groin area to the brain. The stent —made of platinum-titanium mesh and called the Solitaire™ Flow Restoration Device – is guided into the part of a patient’s brain arteries where a blood clot has formed.

The stent expands the interior walls of the artery and allows blood to get to the patient's brain immediately to prevent as much brain damage as possible. The clot seeps into the mesh of the stent. Then, after five minutes, the stent and clot are removed together.

The study was called the SWIFT trial – for Solitaire with the Intention for Thrombectomy. It compared the new stent retriever procedure to a traditional clot removal intervention for strokes. In the traditional procedure, a corkscrew-like device is twisted into the clot and the clot is gently pulled out. Sometimes, more than one attempt is needed to remove the clot.

The study results showed that, compared to the traditional retriever device, the new stent retriever resulted in more people who had an “excellent neurological outcome” — 33 percent with the corkscrew procedure compared to 56 percent with the stent. It also resulted in fewer people dying from their strokes – 17 percent with the new stent versus 38 percent with the corkscrew device.