Grant: Project Grant

Every nine minutes, a Canadian suffers a stroke. They fall to the ground, unable to speak, move or walk. Stroke robs Canadians of their independence and is a major cause of disability worldwide. Fortunately, we can treat stroke. But time matters: time is brain. Canadians lucky enough to arrive at an emergency room within a few hours of a stroke are given a clot-busting drug. This drug helps reverse the effects of stroke, and one in eight patients will walk away from hospital with no disability. This drug was the only treatment available until 2015, when a major breakthrough quickly removed blot clots from the brain. With this new procedure, one in two people now walk away with little to no disability. Doctors have started to wonder if we still need the clot-busting drug. Giving the drug delays the new clot removal procedure. Also, the clot-buster is a strong blood thinner and can cause lethal bleeding. Finally, the clot-buster costs over $2500 a dose, which may not be justified if the clot removal procedure works just as well without it. For these reasons, many believe we should skip the clot-buster and focus instead on speeding up the clot removal procedure. Our team proposes comparing the two approaches to treating stroke. The first approach is the current approach: we give the clot-buster drug as fast as possible, then remove the clot. In the second approach, our goal is to get to the procedure room as fast as possible to remove the clot. While the clot is being removed, we have the option to give the clot-buster, or even avoid giving all together. We believe our study will show that removing the clot is the most important step to help the patient. We may also show that both approaches are the same, in which case each hospital can choose what is best for their patient. Most importantly, our study will find the best way to keep Canadian stroke survivors living independently.