Stroke can be treated. Interventional inside-the-artery treatment

For Physicians
The standard of care for acute ischemic stroke in most of today's hospital stroke centers is the administering of a clot-busting medication tPA (tissue plasminogen activator) within 3 to 4 1/2 hours of symptom onset. However, if the patient has missed the opportunity for early care, or tPA treatment has failed to fully dissolve the clot, alternative lifesaving "inside-the-artery," interventional procedures exist that may be used up to eight hours after the start of symptoms. When clinically appropriate, specialists can use these procedures to physically remove the clot from the artery to restore blood flow to the brain.

This website was developed to educate the public on the importance of immediate medical attention for acute ischemic stroke, and to raise awareness of the range of treatment options available at more advanced Stroke Centers around the country.

To learn more about the Penumbra System®, and interventional clot removal with aspiration technology, please visit www.penumbrainc.com.

On average, a stroke occurs every 40 seconds in the United States.

But, did you know stroke can be treated if you get to the right hospital in time?

Quick, efficient stroke treatment (QuEST) is critical for ischemic stroke victims to help preserve brain cells and reduce the risk of long-term disability, or even death.

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Time & Location

Quick, efficient stroke treatment is critical for the best chance of walking away from
a stroke with minimal, if any impairment. Comprehensive treatment options are only available at more advanced Stroke Centers.

Know Where to Go in Case Stroke Strikes. Join the QuEST.

Find an advanced Stroke Center with comprehensive treatment options near you.

Stroke Can Be Treated
Many people have no idea that stroke can be treated safely and effectively at the right hospital, especially with new, potentially lifesaving options.

The main concern when dealing with ischemic stroke is the preservation of vital brain cells. Ischemic stroke interrupts blood flow to the brain and deprives cells of oxygen and nutrients. The longer someone suffering from stroke waits to be treated once they have started experiencing symptoms, the more blood lost to the brain and the greater the risk of brain damage. Quick, efficient stroke treatment is critical for ischemic stroke victims to help preserve brain cells and reduce the risk of long-term disability, or even death.

Treatment for Ischemic Stroke
tPA
Currently, the most widely used treatment for stroke is a clot-busting medication called tPA (tissue plasminogen activator). It is administered intravenously (through an IV) to help break up the clot and allow blood flow to return to the brain to save it from permanent damage.

It is important to remember that tPA needs to be given to a patient within 3 to 4½ hours from the start of stroke symptoms for it to work. While tPA has been a major advancement in the field of stroke treatment, fewer than 5% of stroke sufferers have access to the drug because they do not arrive at the stroke center in time.¹

Also, if the clot is too big or difficult to dissolve, tPA may not work on its own.

Another Option: Interventional "Inside-the-Artery" Clot Removal
If the stroke victim arrives at the hospital when it's too late for tPA or tPA is not able to fully dissolve the clot, there is an interventional, lifesaving option that many people do not know about referred to as "inside-the-artery" clot removal.

This minimally invasive procedure can be successful up to eight hours after the start of symptoms instead of 3 to 4½ hours like tPA. When needed, physicians will use this procedure to physically remove the clot with aspiration (suction) to restore blood flow to the brain.^2,3,4

Know Where "Inside-the-Artery" Clot Removal is Available
Only advanced hospital stroke centers offer inside-the-artery clot removal. Therefore, it is vital to know where your closest advanced Stroke Center is located so you or a loved one can have the best chance of walking away from a stroke with minimal impairment.

In the event of a stroke emergency, immediately call 911. Discuss hospital options with your EMS (Emergency Medical Service) or ambulance crew and request that you or your loved one be taken to the nearest advanced Stroke Center that offers comprehensive options to treat stroke where you will have access to IV tPA, and inside-the-artery clot removal, if needed.

Find your nearest advanced Stroke Center here.

American Stroke Association. Impact of Stroke. Website http://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Treatment_UCM_310892_Article.jsp#.T0vJrHlS7Nk Updated March 6, 2012. Accessed March 23,2012.
JL Saver et al. Primary Results of the SOLITAIRE™ FR With the Intention for Thrombectomy (SWIFT) Multicenter, Randomized Clinical Trial. Presented at International Stroke Conference (ISC) 2012.
WS Smith. Safety of Mechanical Thrombectomy and Intravenous Tissue Plasminogen Activator in Acute Ischemic Stroke. Results of the Multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) Trial, Part I. AJNR Am J Neuroradiol. 2006;27:1177-82.
AC Flint et al. Mechanical Thrombectomy of Intracranial Internal Carotid Occlusion: Pooled Results of the MERCI and Multi MERCI Part I Trials. Stroke. 2007;38:1274-1280.
D Frei et al. The Penumbra START Trial: Preliminary Results on the Clinical Impact of Pre-treatment CTA Source Image ASPECTS in Endovascularly-Treated Stroke Patients. Presented at: International Stroke Conference (ISC) 2012; February 2012; Louisiana, United States.

Vacuum Cleaner for the Brain
A recent advancement to "inside-the-artery" clot removal is The Penumbra System^®, which acts as a "vacuum cleaner" for the brain, using aspiration or suction to gently remove the clot bit by bit to restore blood flow and increase the chances of a successful recovery.

The Penumbra System has shown to effectively restore blood flow to 92% of patients with nearly one-half (48%) of all patients able to walk away from their stroke experience with minimal if any neurological impairments, regardless of the initial severity of their condition. ⁵

For more information about The Penumbra System^®, visit www.penumbrainc.com