une new procedure for emergency care of stroke has been developed at the bichat hospital. carried out in coordination with the ambulance, fire and neurovascular centers (eight in inner paris), it seems crucial to start to drive channel and the types of cerebral arteries or blocked by a clot and thus significantly improves survival. for now, this is an experience of clinical research conducted only in this institution, and a few dozen patients. the recanalization study led by professor pierre amarenco to housing and treatment of stroke in this hospital has just been published by the lancet neurology. ur 150 000 strokes that occur each year in france, involving 30 000 patients younger than 50 years. a sudden motor weakness or paralysis of half the body, a sudden disturbance of speech, dizziness, visual disturbances, numbness of a body part must immediately is an absolute emergency, get to see. for fifteen years, the standard of care recognized by the french agency for health product safety (afssaps) for patients with stroke by occlusion of a cerebral artery is an enzyme-based treatment of drug users, tissue activator l plasminogen activator (rtpa), which dissolves caillot.ce treatment cures the patient in 40% of cases, but only if the injection is given within three hours after the first symptoms. aptn and does not lead to clogged arteries in the brain in 25 to 60% of cases (and 30% of their patients rebouchent secondary artery). there is another approach: deliver the drug directly into contact with the clot: the end of a microcatheter is mounted on the femoral artery, iliac artery, the aorta and carotid. aptn is injected into contact with the clot (clot kissing). performed within six hours, this technique may lead to the artery in 60 to 70% of the caillotenfin contact cas.

injecté, doctors have invented (and used experimentally) microscopic ties, baskets or corkscrew embedded catheters after go to mechanically remove caillot.l recanalization study combines the two treatments in the diagnosis of stroke is made by the hospitals image aptn is injected into a vein infusion. wasting no time, the patient is taken to the catheterization laboratory. walking up a tube into the artery and the same drug is injected into contact caillot.dans initially, the team of bichat treated with intravenous therapy only 107 of 173 consecutive stroke between february 2002 and april 2007. results: 52% of the arteries were recanalized (uncovered). then, between may 2007 and october 2008, intra-arterial technique in 53 of the 122 patients included in this group and recanalization was effective in 87% of cases. the impact on the number of immediate cures was important: 60% of patients treated with the new method have seen their symptoms improve or disappear from 39% of patients treated with conventionnelle. lus rapid intravenous artery was uncovered, the better the outcome if the intervention is carried out in 3 hours and 30 after the onset of stroke symptoms, 93% of patients are cured immediately and will continue beyond three months suivi.seul issue of this race against time will be costly in human resources and operation of neurovascular emergencies mobilized together with specialists in neuroradiology.

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