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MASTERSTROKE: improving outcomes for stroke patients

Clinical trial will show if different blood pressure management during clot retrieval can improve outcomes from stroke.

Stroke is the third most common cause of death in New Zealand. It's one of the leading causes of long-term disability at all ages.

Lifetime costs of stroke per person were ~$73,600 in 2009, with a total cost of $450 million per year in New Zealand alone.

Stroke is a devastating disease with lifelong disability, dependence on others for care and very high mortality. The burden on patients, carers, health care providers and society will be higher in the most severe strokes.

Patients suffering from ischaemic stroke caused by a blood clot in the brain can undergo a life-saving clot retrieval procedure if they get to hospital within the first six hours of onset. The clot can be removed using a mesh like retrieval device, freeing the clot from the brain.

The MASTERSTROKE clinical trial brings together anaesthetists, radiologists, neurologists, research scientists and patients from all over New Zealand into a clinical trial to investigate if augmenting blood pressure management during this surgery can improve patient outcomes.

Dr Doug Campbell from the Department of Anaesthesia at Auckland District Health Board leads the team studying this sometimes underestimated factor in this procedure.

Dr Doug Campbell
Dr Doug Campbell leads the MASTERSTROKE trial: MAnagement of Systolic blood pressure during Thrombectomy by Endovascular Route for acute ischaemic STROKE

"Many anaesthetic drugs can affect the blood flow within the brain. There is a possible mechanism of benefit from an increased blood pressure target," he says. "Just a few points difference in blood pressure readings may really change the patient's chances for better recovery.

"The intervention of blood pressure augmentation tested in this study adds no additional healthcare costs and would be immediately available to all patients having clot retrieval in New Zealand with more benefit to Māori who form a higher proportion of stroke patients.

"Endovascular clot retrieval is already a highly effective therapy and we think we can make it even better. These further therapeutic improvements will reduce disability, improve quality of life and reduce healthcare costs."


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