New Guidelines Buy Time for Some Stroke Patients

Premier Health Now

When you notice signs of a stroke coming on, dialing 9-1-1 for immediate medical care is still the order of the day. But for some stroke patients, according to newly published guidelines, the narrow window of time for effective stroke treatment may be a little wider than previously thought. 

Who are “some stroke patients? Premier Health Now reached out to Bryan Ludwig, MD, of the Clinical Neuroscience Institute to find out — and to learn more about the new guidelines, which were recently published in the American Heart ssociation’s journal Stroke and announced at the American Stroke Association’s International Stroke Conference.

Strokes occur when a blood clot stops or slows blood flow to a portion of the brain. “Some people have strokes that occur very quickly and their brain cells, unfortunately, die in a very rapid nature,” Dr. Ludwig explains. “But others have brain cells that hang on for hours.” 

Those with the persistent brain cells, according to the new guidelines, could benefit for up to 24 hours after symptom onset from a surgical procedure that removes clots with a device threaded through a blood vessel.

Previously the time limit for the procedure was considered six to seven hours after symptoms started. The longer period, says Dr. Ludwig, “allows us to treat many more patients than may have been treated in the past.”

Dr. Ludwig adds that the most recent trial showed that for patients with stroke symptoms starting more than six hours before they arrive to the hospital (but no more than 24 hours from the onset of the stroke) and who qualified for surgical removal of clots, nearly 50 percent were doing well at three months. This was compared to similar patients who didn’t receive the surgery, where only 13 percent of patients were doing well three months after their stroke.

The new guidelines also suggest that more people could be candidates for the clot-dissolving IV medication alteplase.

Regardless of this good news, Dr. Ludwig urges seeking immediate medical attention at the first sign of stroke and remembering the acronym FAST, which covers stroke symptoms – Facial drooping, Arm weakness, Slurred speech – and a call to action, Time to call emergency services.