By CHRIS LOPAZE
UW News Lab
A grain of rice. That is approximately the size of a stroke victim’s blood clot.
Overlake Medical Hospital is one of three hospitals in the U.S. participating in a FDA trial testing the Separator 3D, a new device to remove ischemic blood clots with less invasive methods.
Dr. Abhineet Chowdhary, director of neurosurgery at Overlake, will be one of the primary doctors handling the device.
“This particular [device] incorporates a lot of the good function of what’s already out there, but combines it into one,” Chowdhary said. “It’s like saying the wheel is good, an engine is good, AC is good, let’s make a car. You don’t want each one of those pieces, but you want the car.”
This device treats only ischemic stroke, an obstruction caused by a blockage in the brain. Veins closer to the brain are smaller compared to veins in the body. As people get older, blood vessels narrow, increasing the risk.
According to the National Stroke Association, stroke is the fourth leading cause of death in the United States, with over 133,000 deaths per year out of approximately 795,000 strokes that occur. Ischemic strokes account for 87 percent of all strokes.
Controllable risk factors for stroke are similar to risk factors for heart disease and cancer, such as smoking, high cholesterol, high blood pressure and living a sedentary lifestyle.
Current methods for treating stroke are an IV tPA-a drug with clot busting properties, administered through an IV-and mechanical thrombectomy, a process done by machines similar to the Separator 3D.
The device is made of a malleable material called nickel titanium alloy, or nitinol, and is soft enough to not damage blood vessels. Inside the sheath, which is a tube, the device is attached to a green wire used to control it.
A different tube is connected to the suction device and to the patient. The device is inserted into tubes already in the patient. The size of tubing becomes progressively smaller in circumference to fit within the increasing smaller vein size closer to the head.
Once the end of the device’s sheath has reached past the blood clot, the device is deployed out of the sheath and opens up slowly, trapping the blood clot into its pockets. After waiting for the clot to stick in the device, the doctor would turn on the suction device and the blood is sucked out.
This allows blood flow to return quicker than traditional devices because of the use of a stent, a scaffolding to open up the clot, resulting in oxygen reaching the brain sooner.
“We always want to improve our safety and make safety the prime concern,” Chowdhary said. “If we can also improve the outcome by getting the blood clot out, fantastic. This stuff allows us to do that, which is great.”
Data gathered from all three locations are sent to one central location and monitored as the results come in, per FDA safety regulations. The trial has started and could last one to two years depending on the results.
If a stroke patient chooses to enter the trial, he or she will be randomly selected for traditional treatment or treatment by the Separator 3D. Each treatment will be administered to half of the patients.
Even with medical advancements, Chowdhary said increasing public awareness is the best thing for stroke care. Many people don’t actually believe a stroke is an emergency, he said, and hence don’t seek immediate care.
“Time is brain,” Chowdhary said. “The more time you spend not coming into the hospital, the more brain that is lost.”
He prefers to call it a “brain attack” in order for people to take it more seriously and not delay getting treated.
“To stay on the cutting edge you have to do clinical trials,” Chowdhary said. “We have been a world class hospital and this is some of the stuff we’re doing to stay on the cutting edge.”
Chris Lopaze is a student in the University of Washington Department of Communication News Laboratory.