The stroke industry is united by a common goal, to develop effective solutions and provide access to treatment which prevents people dying or living a life of dependency because of stroke. World Stroke Day today is a pertinent reminder as to why we work tirelessly, to develop these solutions and deliver the right care so that every 6 seconds a life does not have to be lost to stroke1, as is the situation today.
Let’s be under no illusion, this is a big task, requiring unwavering commitment and collaboration. Stroke is too big of a challenge for anyone to tackle alone. However, through remarkable partnerships, stroke care has benefitted from some incredible advancements since World Stroke Day was established back in 2006. Perhaps once of the most notable advancements was in the late 1990’s with the introduction of the first recognised treatment for stroke, the ‘clot buster’ Tissue Plasminogen Activator (TPA) which worked to the goal of dissolving the blood clot – and it is still widely used today. Some 20 years after that, everything really changed when mechanical thrombectomy was proven as the most significant advancement in the history of stroke treatment, showing improved outcomes when used together with TPA.
It is through collaboration and partnerships that our understanding of and dealing with blood clots has improved enormously and informing advancements in mechanical thrombectomy, whereby clots are removed from the main arteries supplying the brain with blood. However, we are not there yet since stroke is still a global leading cause of death and disability, which means our work is therefore far from done.
My opinion is that ischemic stroke is a battle against blood clots, the main cause of ischemic stroke and accounting for 87% of all cases 2. As in all battles, how do you defeat your opponents? I believe you achieve this by truly understanding them; how they work, their formation, their every detail – so why should blood clots be any different? I don’t think they are.
By building our understanding of the science of blood clots we can create more effective, efficient and safer solutions. We are now in an era where the latest generation stent retrievers are seeing unprecedented clinical outcomes, such as functional independence in 2/3 patients at 90 days, final successful reperfusion achieved in 9/10 patients, and over 50% in the first pass3. If we continue to deepen our understanding what will this mean for patients?
I believe that even today we have only just found the tip of the iceberg in terms of our understanding of blood clots. The battle against stroke is far from over and we must continue our research and remaincommitted to advancing stroke care so that all stroke victims can return to a healthy, independent life. And so as we move forward, survivors will continue to benefit from the continuously evolving knowledge we have of stroke, its treatments and the recovery phase.
- World Stroke Organization The Facts Behind “1 in 6” . [Online] https://www.worldstrokecampaign.org/learn/the-facts-behind-1-in-6.html f. [Last accessed October 25, 2018].
- Everything You Should Know About Ischemic Stroke https://www.healthline.com/health/stroke/cerebral-ischemia .[Last accessed 18 October 2018]
- Zaidat O, Bozorgchami H , Ribo M, Saver J, Mattle H, Chapot R, Narata A, Francois O, Jadhav A, Grossberg J, Riedel C, Tomasello A, Clark W, Nordmeyer H, Lin E, Nogueira R, Yoo A, Jovin T, Siddiqui A, Bernard T, Claffey M, Andersson T. Primary Results of the Multicenter ARISE II Study (Analysis of Revascularization in Ischemic Stroke With EmboTrap). Stroke, 2018