It’s no secret that one of the biggest issues in stroke care is the timely arrival of patients to the hospital. The one FDA-indicated drug available for acute ischemic stroke, IV-tPA, must be used within three hours of stroke onset according to FDA indications. The American Stroke Association, however, updated guidelines in 2009 to extend that window to 4.5 hours. By either treatment window, however, few patients are coming into the hospital to receive tPA.
Little progress seen in arrival times for ischemic stroke
Yesterday, Covidien announced that it had received FDA clearance for its Solitaire FR revascularization device. The approval brings a new option in mechanical thrombectomy devices—a class of technology that has been limited to two devices and seen no new entrants in nearly five years.
Solitaire demonstrated superiority to Concentric Medical’s Merci Retrieval system in the Solitaire With the Intention for Thrombectomy (SWIFT) clinical study, which was halted early because of the strength of initial results.
Covidien's Solitaire launches next generation of mechanical thrombectomy devices for ischemic stroke
In the United States, we see nearly 800,000 strokes each year—amounting to a new or recurrent stroke occuring every 40 seconds. Fortunately, with notable improvements in care, many more people are surviving strokes than in the past. Stroke survival, however, brings its own set of demands on the health care delivery system, with many patients needing extensive support from physicians, therapists, and family members.
Current efforts around developing certified Comprehensive Stroke Centers (written about earlier this week on The Pipeline) are focused on enhancing acute and post-acute care for stroke, but with much of the health care dialogue centered on population care management, a focus on stroke prevention may become a more realistic goal for the delivery system.
An article published last week in BMJ Open suggests that the possibility of reducing the incidence of stroke can be realized through improved management of known risk factors. While the study arrives at its conclusion in a weak manner, the story is compelling.
Stroke prevention: A possibility under accountable care?