Clot-buster drug saving patients' vital functions

Quick attention vital in strokes

The clot-busting drug tPA has put six stroke patients back on their feet, and spared another 10 from major disability, since it was first used in Palmerston North two years ago.

Feilding resource teacher Chris Barbridge was one of the beneficiaries.

Paralysed down her left side when she was rushed to hospital, the next day she delighted the doctor who tested sensation on the sole of her foot with a spirited kick.

And then she got up and walked.

"It's one of the most rewarding things of my job, to see someone come into ED being paralysed and then walking out of the hospital only a few days later," said her neurologist Anna Ranta.

But it wasn't just the miracle drug that saved her from life in a wheelchair.

It was the prompt reaction of husband Kevin, who, alerted by his 53-year-old wife's "weird" coughing, took one look at her lop-sided expression and thought, `you're having a stroke'.

He called an ambulance, turned off the roast dinner, and was in the emergency department discussing thrombolysis (breaking down clots) within an hour.

That speed provided the opportunity to use the drug successfully – it needs to be administered within three hours.

"Kevin was one of the main reasons for this excellent outcome as he acted fast to bring her to ED [the emergency department] in time for us to administer tPA," Dr Ranta said.

The drug can be used on patients having an ischaemic stroke – caused when a clot blocks the blood supply to the brain. It dissolves the clot before all the damage to the affected part of the brain is permanent.

The drug is not without risks.

About one in 20 patients have a major bleed that can be fatal – which is about the same odds as dying from an untreated stroke.

One of the 17 patients treated with tPA by Dr Ranta has died. But for the other 16, it slowed the stroke in its tracks, restoring various degrees of function within hours.

It wasn't the end of treatment for Mrs Barbridge.

A carotid ultrasound showed one of the arteries to her brain was 90 per cent blocked, so she had to go to Wellington for vascular surgery to have the blockage cleared to reduce the risk of another stroke.

The next six weeks were as much about recovering from surgery as shaking off some left hand tremors and the emotional blues that were the remaining symptoms from the stroke.

"There are still some little things I find more difficult than before, but I'm still improving," Mrs Barbridge says.

- © Fairfax NZ News