United States: According to medical professionals, after a stroke, “time is brain,” with neurons starting to die off within minutes. It’s critical to determine the sort of stroke a patient has experienced as soon as possible. An experimental blood test could now expedite that procedure.
Innovative Treatment
A group from Boston’s Brigham and Women’s Hospital claims that their test can accurately ascertain whether a patient has experienced large vascular occlusion (LVO), a very deadly kind of stroke.
Once that’s established, the test allows physicians to proceed with a mechanical thrombectomy, a surgical procedure that quickly removes the LVO clot from any major artery that supplies the brain.
Expert Insight
According to a hospital news release, senior study author Dr. Joshua Bernstock said, “Machine thrombectomy has allowed people who would have otherwise died or become significantly disabled to be completely restored, as if their stroke never happened.”
“The patient’s outcome will be better the earlier this intervention is implemented,” Bernstock, a clinical fellow at the hospital’s neurosurgery department, continued. “More people worldwide may be able to receive this treatment more quickly thanks to this innovative new technology.”
Biomarker Analysis
Various stroke kinds produce various “biomarkers” in blood as they occur, as Bernstock’s team was previously aware.
They specifically examined two proteins: D-dimer and glial fibrillary acidic protein (GFAP), which have long been connected to traumatic brain injury and brain bleeding.
Blood tests that quantify such proteins aid in ruling out bleeding strokes, whose symptoms are sometimes mistaken for those of lung varicellation (LVO).
Research Findings
According to Bernstock’s research, combining the findings of the blood test with a “field assessment stroke triage for emergency destination” (FAST-ED) score may help identify a patient’s LVO more rapidly.
Utilizing information from 323 patients treated for stroke in Florida in 2021 and 2022, the team tested their assumption.
“Combining the levels of the [blood] biomarkers GFAP and D-dimer with FAST-ED data less than six hours from the onset of symptoms allowed the test to detect LVO strokes with 93 percent specificity and 81 percent sensitivity,” the investigators stated.
Eight1% sensitivity indicates that the diagnostic tool identified a genuine LVO 81% of the time, while 93% specificity indicates that it was correct 93% of the time in determining that the stroke was not an LVO.
Clinical Implications
“A game-changing, accessible tool that could help ensure that more people suffering from stroke are in the right place at the right time to receive critical, life-restoring care” is how Bernstock described the new diagnostic approach.
According to his team, in an emergency, the test may also be used to identify or rule out brain bleeds. It could be especially helpful in developing nations where access to advanced diagnostic imaging may be limited.
Potential Impact
The journal Stroke: Vascular and Interventional Neurology published the findings on May 17. The researchers now intend to evaluate the new test in ambulances to see how well it works.
According to Bernstock, “a patient will do better the sooner they are put on the right care pathway.” “Using the technology we built, it will be incredibly transformative to be able to do this in a pre-hospital setting, whether that means ruling out bleeding or ruling in something that needs an intervention.”