Stroke prevention and mitigation is a cause near and dear to my heart, since so many of my relations have had to deal with strokes of varying degrees of severity. If you can imagine such a fantastical device, doctors in Canada have managed to insert a teeny tiny vacuum aspirator in a blood vessel starting at a patient’s groin. Using various imaging techniques, they then guide the thing all the way from the groin to the brain, find the stroke-causing blood clot, and aspirate it away before too much damage can be caused to local brain tissue by the disrupted blood supply.
On the surface, it’s a perfectly sensible approach to ischemic stroke brain damage mitigation and has a certain ring of “why on earth didn’t they think of this before?” to it. If one stops and considers the magnitude of the technical hurdles this team had to surmount, though, the mind just boggles. There are literally MILES of blood vessels in the human body, with a respectable percentage dedicated to the lace-like network of fine vessels that serve the brain. The medical team has to first FIND the clot, then plot a course, and then start to navigate the intervening feet of vasculature, none of which they can actually see, mind you. They rely on other imaging techniques to know where they are. They are doing all of this in the context of the immediate aftermath of an ischemic stroke, where time is of the incredibly crucial essence. If they haven’t aspirated the clot within the first hour or two, they might as well have not even tried.
Bottom line, this represents an excellent breakthrough for victims of severe strokes. Smaller strokes are more difficult to treat with this method, given the smaller size of the clots – there isn’t as much of an improvement in these patients, and it’s difficult to justify the difficulty and expense in patients who won’t benefit much, if at all, in the first place. The whole procedure sounds like something out of a science fiction story (yes, Dr. Smith just vacuumed a blood clot out of the patient’s brain to save him from a horrible fate!), and I think it’s a marvelous advance for the field of ischemic stroke care.