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Strokes associated with surgery can be devastating
Date:2/11/2013

surgeries such as muscle biopsies and dental procedures.

Delivering rtPA by catheter. In this procedure, a high concentration of the clot-busting drug is delivered by a catheter directly to the clot. But using this technique in any patient population, surgical or otherwise, "is not currently substantiated by randomized controlled trials," the authors write.

  • Mechanical clot busting. Catheter systems such as MERCI, Penumbra and Solitaire, which use mechanical devices to bust clots, have been deemed safe by the Food and Drug Administration. But these systems are "untested and unproven in perioperative stroke," Morales and Schneck write.

  • Ultrasound. Sonothrombolysis uses ultrasound to enhance the break-up of blood clots in the brain. "The evidence for sonothrombolysis in stroke is far from conclusive, and the perioperative population is unstudied," the authors write.

  • Hemicraniectomy. Large strokes can cause life-threatening brain swelling. A hemicraniectomy is surgery to relieve the swelling. The surgeon temporarily removes part of the skull, allowing the swollen brain to expand beyond the confines of the skull. "In appropriate cases, hemicraniectomy has shown clear benefit, improving survival and functional outcomes," Morales and Schneck write.


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  • Contact: Jim Ritter
    jritter@lumc.edu
    708-216-2445
    Loyola University Health System
    Source:Eurekalert

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