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Optimizing stroke therapy - advanced brain imaging and rapid restoration of blood flow to the brain

Professor Bruce Campbell, Institution: University of Melbourne

2015 Future Leader Fellowship

Years funded: 2016-2020


Most strokes are caused by reduced blood flow due to a blocked blood vessel in the brain. Recent advances in stroke therapy, including the EXTEND-IA randomized trial of minimally invasive “endovascular” treatment via angiogram to physically remove the causative thrombus (CIA Campbell, NEJM 2015), have potential to transform patient outcomes.

This research addresses key questions about the optimal use of therapies to restore blood flow to the brain. The EXTEND-IA TNK randomized trial will test whether a clot-dissolving medicine (Tenecteplase) can restore blood flow prior to endovascular therapy better than standard alteplase medication.

Tenecteplase is already used for heart attack patients and pilot data in stroke suggests it may be safer and more effective. We will address whether pre-hospital paramedic identification of severe stroke with bypass direct to an endovascular-capable hospital will lead to faster treatment and improved outcomes compared to current transport protocols. We have formed a global collaboration to pool endovascular trial data.

Dr Campbell is responsible for the advanced imaging analyses which will further refine the role of advanced imaging in patient selection for endovascular therapy, particularly in identifying patients who may be harmed by therapy. Together these projects have the potential to improve access to the most effective stroke therapies and guide health system design to manage geographical and resource constraints in the Australian context.

This project is co-funded with NHMRC - National Health and Medical Research Council.

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