Study Seeks to Improve Treatment After Stroke
Library: MED
Keywords: STROKE TREATMENT NEUROLOGY NEUROSURGERY CAROTID ARTERY BLOCKAGE MIDWEST
Description: Researchers at the University of Illinois Medical Center at Chicago and Rush-Presbyterian-St. Luke's Medical Center will try to determine the most effective treatment for patients who recently have had either a stroke or a transient ischemic attack due to a complete blockage of one of their carotid arteries.



Nan Hoffman
E-Mail: nanhoff@uic.edu
Phone: (312) 355-2954

Study Seeks to Improve Treatment After Stroke

Researchers at the University of Illinois Medical Center at Chicago and Rush-Presbyterian-St. Luke's Medical Center hope to determine the most effective treatment for patients who have recently had either a stroke or a transient ischemic attack (a brief interruption of blood supply to part of the brain) due to a complete blockage of one of their carotid arteries.

"We're hoping to become better informed about the best way to go about treating these conditions, which can have such devastating consequences," said Dr. Fady Charbel, professor and interim head of neurosurgery at the UIC College of Medicine. Charbel, the principal investigator on the study for the Central Midwest, will work with Dr. Sean Ruland, a neurologist at Rush.

A stroke occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood and oxygen flow to an area of the brain. When this occurs, brain cells in the immediate area die creating a condition that may lead to reversible or irreversible paralysis. Depending on the area of the brain that is damaged, a stroke can also cause coma, speech problems and dementia.

Transient ischemic attack (TIA) symptoms, which usually occur suddenly, are similar to those of a stroke but do not last as long, and full recovery usually takes place within 24 hours.

Patients eligible for the study include those who have had either smaller strokes or TIAs due to a complete blockage in one of their carotid arteries. The researchers will use a special oxygen isotope in conjunction with a positron emission tomography, or PET scan, to determine if the patient is eligible for the study.

Ruland said previous studies using the isotope with PET scans have shown that people who have low detectable levels of the isotope have higher rates of stroke than those with higher levels. When the PET scans detect a small amount of the isotope, the patient is a good candidate for the study.

Patients will be randomly assigned to receive either medical management or surgery. Those patients randomized for surgery will receive care from Charbel, who will remove a portion of the superficial temporal artery and graft it onto the blocked artery, thus redirecting the blood flow around the blockage.

Patients will then be followed-up every three months for at least two years to monitor their condition.

Approximately 730,000 people experience first-ever or recurrent strokes each year in the United States. Ten to 15 percent of these patients have blockages in one of their carotid arteries.

Currently, patients who suffer strokes associated with severe narrowing by cholesterol plaque in this area either undergo surgery to remove the plaque or are treated with platelet inhibitory drugs.

For those patients with complete blockages, the treatment is less certain, and they are commonly treated with medication as the plaque cannot be removed safely at this point. If symptoms persist despite medication, bypass surgery is sometimes considered as a last resort.

Surgery requires that the artery in the temple be redirected so that it funnels more blood to the area of the brain affected by the stroke.

For more information about the study, contact Kate Walsh at 1-800-597-5970.

The study is funded by the National Institutes of Health and will take approximately five years to complete.

The media contact at Rush-Presbyterian-St. Luke's Medical Center is Chris Martin, (312) 942-7820; Christopher_D_Martin@rush.edu

For more information about UIC, visit www.uic.edu