Bursting blood clots: Medicine's next big thing?

Every moment counts when someone suffers a stroke, most of which are caused by a blood clot that blocks the flow of blood to the brain. Doctors are testing a new medical breakthrough that could help stroke victims.

Dr. George Shaw and researchers at the University of Cincinnati, College of Medicine are testing a trailblazing technique to dissolve human blood clots more quickly. They are using a natural enzyme called plasmin.

The plasmin is loaded into a special bubble called a liposome. Through an IV, doctors send it directly to the blood clot.

"I think it's going to be a major step forward for stroke therapy,” said Shaw.

Right now, if stroke victims can get help within three hours, they will likely receive a drug called TPA, but Dr. Arthur Pancioli, an expert in emergency medicine, warns of the risks.

“That drug, one in about 16 patients that you treat, 16 or 17, will have bleeding into the brain,” he said.

The plasmin process carries no risk of bleeding. However, as with TPA, doctors would still need to give the plasmin within three hours of the onset of stroke.

Clinical trials with plasmin could start in five years.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: BURSTING BLOOD CLOTS: MEDICINE'S NEXT BIG THING?
REPORT: MB #3710
BACKGROUND: A stroke may also be considered a brain attack that happens when a blood clot blocks an artery. This prevents blood flow from the heart to the body causing dead brain cells and brain damage. When a stroke occurs, the abilities that are controlled by that part of the brain are lost due to the damaged brain cells. Motor functions such as memory, movement, and speech are all affected from a stroke and recovery is questionable. Recovery depends on the patient and the motivation to get better, as well as the location of the brain where the stroke occurred. (Source: http://www.stroke.org/site/PageServer?pagename=stroke)
PREVENTION: To prevent having a stroke, one might consider making a couple of lifestyle changes. Blood pressure, cigarette smoking, and alcohol are three main factors of how a stroke might occur. Cholesterol, diabetes, and weight can also be managed to be sure that you are not at risk. Transient Ischemic Attack (TIA), atrial fibrillation, and circulation are three conditions to be aware of when preventing a stroke. TIA is an incident that consists of stroke-like symptoms that last temporarily. 40 percent of individuals who experience TIA will have a stroke. (Source: http://www.stroke.org/site/PageServer?pagename=prevent)
SIGNS: The acronym F.A.S.T. was created to teach patients of potential stroke symptoms. "F" stands for face. If one side of the face is drooping while smiling, that could be a sign of stroke. "A" stands for arms; ask the person to raise their arms to see if one is also dropping. "S" is speech; ask the person to repeat a phrase and listen for slurring. "T" stands for time; use your time wisely if any of these signs occur and seek medical help. (Source: http://www.stroke.org/site/PageServer?pagename=prevent)
NEW TREATMENT: A new study from the University of Cincinnati College of Medicine has found that, when delivered via ultrasound, the natural enzyme plasmin is more effective at dissolving stroke-causing clots than the standard of care, recombinant tissue plasminogen activator (rt-PA). The delivery method involves trapping plasmin in bubble-like liposomes, delivering them to the clot intravenously and bursting it via ultrasound. "That method is necessary," UC associate professor of emergency medicine George Shaw III, MD, PhD, was quoted as saying, "because plasmin cannot be delivered through traditional methods. Intravenous delivery of rt-PA is designed to solve that problem by catalyzing the conversion of existing plasminogen inside the body to plasmin, which in turn degrades blood clots." In in-vitro study, Shaw and researchers enclosed plasmin and a gas bubble inside a liposome. Then, they delivered the liposome to a clot in an in-vitro lab clot model and dissolved it using ultrasound waves, thus delivering the plasmin enzyme to the clot. After 30 minutes, clots treated with plasmin showed significantly greater breakdown than clots treated with rt-PA. (Source: http://www.med.uc.edu/Home.aspx)
FOR MORE INFORMATION, PLEASE CONTACT:

Katy Cosse
Public Information Officer
University of Cincinnati Academic Health Center
Public Relations and Communications
(513) 558-0207
kathryn.cosse@uc.edu
HealthNews.uc.edu


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