How a stent can clear a blood clot in brain stroke in 24 hours

Hope for brain stroke patients: Brain stroke, or cerebral palsy, is a medical emergency in which blood circulation to a part of the brain is interrupted. Due to this, Ben’s cells do not get oxygen and nutrients and they start dying. Due to brain stroke, many types of problems can occur in the affected part of the brain, such as difficulty in speaking, walking, seeing, or thinking. If not treated in time, it can be fatal.

But for some time now, brain damage in brain stroke patients can be prevented in Western countries. Because neurosurgeons used a sophisticated Retriever stent to clear blood clots from blocked arteries and restore blood flow within 24 hours. Although cases of brain stroke are increasing in India, this device is out of reach of most Indians.

A trial is going on in AIIMS Delhi
According to a report in The Indian Express, this situation is about to change. Because Delhi’s All India Institute of Medical Sciences (AIIMS) is conducting trials with an advanced device, which is capable of removing all types of blood clots. This blocks arteries better and can cost one-fourth of the original price. GRASSROOT (Gravity Stent-Retriever System for Reperfusion of Large Vessel Occlusion Stroke Trial, GRASSROOT), a new generation of advanced stent-retriever devices, is being tested in clinical trials. Which can be used in stroke surgery to clear blockage of arteries in the brain.

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Designed for India
According to Dr. Shailesh Gaikwad, Professor and Head of the Department of Neuroimaging and Interventional Neuroradiology, Neurosciences Center of AIIMS, “We are finding out how this device works on Indian people. “The new stent-retriever has been specifically designed keeping in mind the specific characteristics of stroke clots in the Indian population, as our arteries are narrower.” This new device was used for the first time on August 25. The patients on whom it was tried are now fine. Dr. Shailesh Gaikwad is also an investigator of this trial.

What is stent-retriever?
A stent-retriever is a thin, cylindrical mesh tube that is inserted through a catheter and expanded within the artery to widen the vessel walls. Once the clot gets stuck in the mesh of the stent, it is pulled out by the catheter. There is no need to deploy it permanently. It can be removed within ten minutes and blood circulation in the brain can be rapidly restored.

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Is it better than existing equipment?
Dr. Gaikwad says, “It provides rapid and complete restoration of blood circulation in the brain. Whereas in IV infusion, 50 percent of the dose is given immediately and 50 percent is given at an interval of 12 hours. During these hours, the artery should open, but it cannot be predicted how quickly this will happen. This may happen within 10 or 12 hours. In the meantime, there is no way to monitor whether the drug is effective or whether the clot is breaking down. “The stent-retriever has immediate results.” Furthermore, IV infusion only works if the patient arrives within six hours of a brain stroke. After this, the only treatment left is mechanical thrombectomy.

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Why is this study important for India
According to Dr. Deepti Vibha, Additional Professor, Department of Neurology, another investigator of this study, “The main objective of this trial is to evaluate the safety and effectiveness of an advanced stent-retriever in the Indian population. The second objective is to see to what extent patients can regain their functionality.” he said “We are preparing clinical data for approval of this device in India. It is already approved in Southeast Asia and has successfully treated more than 120 patients in the last six months. If successful, it could help meet the acute stroke care challenge in India.” “Only 4,500 of the estimated 3,75,000 stroke patients each year receive life-saving mechanical thrombectomy treatment, so the need for access to stroke intervention is greater than ever,” says Dr. Vibha.

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Why are our brain clots different?
Dr. Gaikwad explains that the blood vessels of Indians are not of the same size as those of people in western countries. He said, “Their average height is six feet, whereas ours is 5 feet 6 inches. The average age of their brain stroke is 60-70 years. Indians suffer from such strokes 10 years earlier, i.e. at the age of 40-50 years. So if we are 10 years ahead in terms of stroke, we need to understand the long-term effectiveness of the device. “Our eating habits, sedentary lifestyle, early diabetes and high blood pressure, as well as distorted lipid profiles, mean that the nature of stroke is different from that of people in Western countries.”

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In which hospitals the trial is taking place
This trial is being conducted in 16 hospitals in India, including AIIMS Delhi, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) and Zydus Hospital, Ahmedabad. Dr. Gaikwad says, “More and more people will get practical training and this will help in capacity building.”

Can stents be manufactured in India?
Dr. Gaikwad says that if approved for use, AIIMS will seek permission from the government and regulatory authorities for domestic manufacturing of this device. He said, “We have the technology and we also have a research and development wing. “In this way we can reduce the cost by one-fourth.”

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