Combination Treatment for Stroke

Ivanhoe Newswire
Tuesday, August 15, 2006; 12:00 AM

(Ivanhoe Newswire) -- A new combination treatment for stroke could mean higher survival rates and better recoveries. Researchers from a new study report combining a clot-busting drug for ischemic stroke -- or a clot blocking blood flow to the brain -- with a drug that prevents new clots could save more lives.

Some patients who experience ischemic stroke -- the most common form of stroke -- are treated with recombinant tissue plasminogen activator (rtPA) in an attempt to dissolve the clot and open blocked arteries. This treatment does not work for everyone.

A new study led by researchers at University of Texas-Houston Medical School reveals rtPA in combination with a drug called Argatroban could help get blood flowing to the brain in more patients.

Argatroban is approved for use in heart attack patients to prevent clots but has not been approved for stroke patients. Animal studies revealed Argatroban with rtPA is successful in increasing blow flow, opening blood vessels faster, and avoiding recurring blockages.

Researchers tested the combination treatment in 15 stroke patients with blockages in the cerebral arteries. Patients received a normal dose of rtPA an average of 118 minutes after symptoms occurred, and in the next hour patients were given a substantial dose of Argatroban, with the exception of one patient who showed signs of hemorrhage. The treatment was completed with a 48-hour infusion.

The arteries of four patients opened completely within two hours, the arteries of six patients became partially opened, two patients had hemorrhaging, one experienced asymptomatic bleeding, and one patient died.

The researchers report that a risk of Argatroban, bleeding in the brain, is mitigated by the drug's short half-life and thus makes it a safer choice for combination treatment than other blood thinners. A larger trial of the treatment is underway.

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SOURCE: Archives of Neurology, 2006;63:1057-1062