One-quarter of patients who had clot-busting drugs delivered directly into their blood clot within six hours of a stroke experienced a "miraculous" recovery within a day, researchers report.
But the route to achieving this "Lazarus Phenomenon" is still experimental and unlikely to become standard practice any time soon. "This therapy of putting the drug directly into a clot is not an approved use," said Dr. Donald DiPette, chairman and professor of internal medicine at the Texas A&M Health Science Center College of Medicine and Scott & White Hospital. "And it's a small study. It has to be reproduced. "But the excitement is that this miracle happens," DiPette added. "The study is important. It worked, it gives us more insight and shows that we can reverse stroke, but it's not immediately applicable to everybody." The findings were to be presented Thursday at the American Stroke Association's annual meeting in San Francisco. An estimated 700,000 people in the United States suffer a stroke each year and about 150,000 people die of stroke, making it the third leading cause of death in the country. Between 15 percent and 30 percent of stroke survivors suffer permanent disability. Currently, the only approved treatment for ischemic stroke is intravenous delivery of tissue plasminogen activator (tPA), the "clot buster," within three hours of the onset of a stroke. Ischemic strokes, which are caused by blood clots, represent more than 80 percent of all strokes. The intra-arterial delivery of clot-busting drugs directly into a clot using microcatheters increases the risk of bleeding and is not FDA-approved. The Lazarus Phenomenon takes its name from Lazarus, who, in the New Testament, was raised from the dead by Christ. The authors of the new study, based at Ohio State University College of Medicine, wanted to see what factors contributed to the Lazarus Phenomenon. So, they collected data on 102 patients aged 18 to 90 who had had an ischemic stroke and were treated with intra-arterial clot busters three to six hours after their stroke. Almost one-quarter (24.5 percent) of the patients experienced the Lazarus Phenomenon, defined as at least a 50 percent reduction in their National Institutes of Health Stroke Scale score 24 hours after treatment. The scale assesses stroke impact based on the severity of each physical deficit, including limb paralysis, vision loss or speech problems. Time-to-treatment had a more significant effect on recovery than age, gender, blood sugar or blood pressure, the researchers said. Average time-to-treatment was 208 minutes for the patients who experienced the Lazarus Phenomenon, compared with 306 minutes for those who did not. It's likely that only specialized medical institutions would ever use this technique. "This method is much more invasive and much more difficult to do," DiPette said. And getting to stroke victims in three to six hours is also difficult, especially in light of another study being presented at the San Francisco meeting that found that 50 percent of people can't recognize the symptoms of a stroke. "The sooner you did this, the more effective it was, so within three hours of the first symptom," DiPette said. "That's a short period of time. Getting to an institution that can do this within three hours is going to be a challenge." But even these limitations don't reduce the ultimate promise of the findings. "It's exciting, nevertheless, because we've never done any studies like this before in stroke," DiPette said. "Now we have some early indication that we can actually affect stroke, just like we can affect heart attack. There's hope. With continued research, we might be able to reverse an acute stroke." | 
