| Barrow Neurological Institute
The Barrow Stroke Center has been investigating stroke-related issues for more than two decades. Barrow researchers are studying genetic factors related to stroke, new diagnostic imaging for early detection of stroke, drugs and techniques to treat acute stroke, new ways to open blocked arteries, and better methods to prevent stroke and to manage rehabilitation.
Angioplasty and Stenting
Barrow is one of 50 major centers participating in a national research study, CREST (Carotid Revascularization Endarterectomy versus Stenting Trial), which evaluates the effectiveness of endarterectomy (surgery to clean plaque out of arteries) in comparison with stenting.
Cholesterol-Lowering and Anticoagulant Agents
Barrow recently participated in two international trials of cholesterol-lowering and anticoagulant agents: SPARCL and SPORTIF. SPARCL (Stroke Prevention and Aggressive Reduction of Cholesterol LDL) tested a cholesterol-lowering agent for stroke prevention. SPORTIF (Stroke Prevention Oral Thrombin Inhibitor in Atrial Fibrillation) tested a novel anticoagulant for stroke prevention in patients with atrial fibrillation (the most common cardiac-related cause of stroke).
Figure 1. CT Angiogram from a patient with an acute ischemic event shows an abrupt cut off (arrow) in the right middle cerebral artery consistent with an occlusion.
Barrow Stroke Center has established a database of more than 9,000 patients who have previously suffered a stroke. The Barrow stroke database has generated information about ethnic differences in stroke among white, Hispanic, and Native American patients. The database produces a wealth of information that allows clinician-scientists to analyze causes, treatment, and prevention of stroke in subgroups.
Stroke Imaging Research
Barrow researchers are studying the applications of CT angiography, CT perfusion, MRI diffusion, MR angiography, and transcranial Doppler for stroke diagnosis and acute intervention. See Fig. 1.
The primary objectives of this work are:
- to specify the circumstances in which these imaging techniques are complementary
- to identify the situations in which each imaging technique is preferred, and
- to explore engineering and computerized methods of advancing the accuracy of these techniques.
Thrombolysis in Acute Stroke Treatment (tPA)
Figure 2. Before tPA treatment, the arrow shows blocked middle cerebral artery (A), after treatment (B).
Barrow stroke neurologists are assessing therapies for acute ischemic stroke agents through study protocols intended to achieve the following:
- Extend the time window in which intravenous tPA can be administered safely and effectively
- Accelerate opening of blocked arteries by combining tPA with mechanical devices or transcranial Doppler ultrasound waves to break up blood clots and restore blood flow.
Figure 2 shows a blocked middle cerebral artery before and after tPA treatment.
Future Directions in Stroke Research
Stroke remains one of the top three causes of death and the leading cause of disability. The direct and indirect costs of stroke are estimated to be more than $57 billion annually. As the baby boomers reach their senior years, stroke is becoming even more prevalent. It is critical that we invest in the effort to reduce the devastating effects of stroke on our population.
The following websites have further information about clinical trials related to stroke. The following website links are provided for your convenience only. These websites are independent of Catholic Healthcare West (CHW) and Barrow Neurological Institute. As such, Barrow and CHW do not endorse or sponsor any of these sites, nor do we vouch for the any of the information contained within these sites.