When a large artery is blocked or occluded, also known as an ischemic stroke, the UPMC Stroke Institute uses advanced therapies to restore blood flow and help improve outcomes.
Depending on the patients condition, the size of the clot, and the hours passed since the onset of symptoms, these therapies can include the following treatments.
Clot-Dissolving Drugs
Clot-dissolving drugs are given within four-and-a-half hours of the onset of symptoms. Tissue plasminogen activator (tPA) is given through a vein in the arm after the doctor has confirmed the stroke's cause, and there is no evidence of bleeding.
Mechanical Clot Removal Devices to Loosen and Remove Clots
During a mechanical clot removal procedure, a catheter is threaded into an artery at the groin and up through the neck, until it reaches the blood clot causing the stroke.
This procedure can also be used on select patients who present with stroke outside of the window for IV tPA or who are not able to receive the treatment due to a medical condition or medications they take.
Using x-ray guided imaging, a stent retriever is inserted into the catheter. The stent reaches past the clot, expands to stretch the walls of the artery so blood can flow, and is finally “retrieved” — pulled backwards — which removes the clot. Learn more about mechanical clot removal.
Intra-Arterial Thrombolytic Treatment
Uses a long tube threaded through a blood vessel and into the brain to deliver clot-dissolving drugs, such as tPA, to the site of a blood clot causing a stroke. Because this method delivers a relatively high dose directly to the clot, it may be more effective and cause fewer side effects than delivering these medications to the whole body.
This procedure can also be used on select patients who present with stroke outside of the window for IV tPA& or who are not able to receive the treatment due to a medical condition or medications they take.
Surgical Treatments
In addition to advanced therapies, surgery may be performed following an ischemic stroke or transient ischemic attack (TIA) to prevent a recurrence.
Surgical techniques include:
- Carotid endarterectomy removes fatty deposits from a carotid artery, a major artery in the neck that leads to the brain.
- Extracranial/intracranial bypass reroutes the blood supply around a blocked artery using a healthy scalp artery.
Additional Stroke Treatments
Investigational therapy
An investigational therapy, neural implantation for stroke, first performed at UPMC, uses minimally invasive surgery to place engineered nerve cells in stroke-damaged areas of the brain.
UPMC studies of neural implantation have provided the first preliminary evidence that implanted cells can grow and take the place of nerve cells killed by a stroke.
Stroke rehabilitation
Some stroke patients can benefit from stroke rehabilitation. The UPMC Stroke Institute offers a comprehensive stroke rehab program to help patients recover deficits the best they can.
Make an Appointment
To schedule an appointment, please call 412-232-8840 or complete a contact form.
Stroke Resources