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New treatment safe, effective to dissolve blood clots in brain: Johns Hopkins clinical trial

A multicenter clinical trial led by Johns Hopkins researchers confirmed that a new treatment that treats a subset of stroke patients by combining minimally invasive surgery, an imaging technique likened to 'GPS for the brain,' and the clot-busting drug t-PA is safe and effective.

The treatment was developed in order to minimize mortality rates of patients with intracerebral hemorrhage (ICH).

Researchers tested new treatment on 60 patients at 12 hospitals in the US, Canada, the UK and Germany.

They compared the results to those of 11 patients who received only supportive care.

After neurologists diagnosed patients in the treatment group with ICH at these hospitals, surgeons drilled dime-sized holes in patients’ skulls close to the clot location.

Using neuro-navigational software that provides detailed brain images, the physicians threaded catheters through the holes and directly into the clots.

They used these catheters to drip t-PA into the clot for up to three days at one of two doses, either 0.3 mg or 1 mg, every eight hours.

The researchers found that clot size in patients treated with either dose shrunk by more than half, compared to only 1% in patients who received only supportive care.

Johns Hopkins University School of Medicine Neurology professor Daniel Hanley said they are confirming that patients do recover better if they gently remove clot as much as they can.