Ekos, Swedish Aim to Shake Up Stroke Treatment with Ultrasound Brain Clot Buster

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Innovation stories don’t get more local than this. A local medical device company provides an innovative tool to a local doctor, who gets money from local taxpayers to test the idea. And, before you dismiss this as some irrelevant insider-y project, an independent expert from Boston has said publicly that this Seattle collaboration may transform the way doctors treat a common type of stroke.

This new technology for the treatment of hemorrhagic stroke is the product of a partnership between Bothell, WA-based Ekos, neurosurgeon David Newell of the Swedish Neuroscience Institute in Seattle, and a $170,000 grant from Washington state taxpayers via the Life Sciences Discovery Fund.

The idea is to treat burgeoning clots in the brain sort of like how clots are treated in other parts of the body. Ekos is known for having developed a miniature ultrasound probe that slithers inside blood vessels, and gently amplifies clot-dissolving drugs. The hope is to get rid of clots faster, which ought to help people live healthier lives after they get out of the hospital. The company markets this tool for people with clots in the legs, known as deep vein thrombosis, and it is trying to expand into a broader patient population of people with dangerous clots in the lungs, known as pulmonary embolisms.

But Newell, and Ekos, saw another group of gravely ill patients who might benefit—those who suffer from hemorrhagic strokes. This is what happens when a blood vessel ruptures in the brain (usually from uncontrolled high blood pressure), which creates dangerous swelling and clots. About 100,000 patients in the U.S.—one-fifth of all stroke patients—are diagnosed with this form of stroke every year. While doctors sometimes try to surgically remove the squishy new clot, the disease is fatal about half of all cases, Newell says.

David Newell

David Newell

There is no effective treatment for hemorrhagic stroke, although some evidence has emerged lately to suggest that clot-dissolving drugs like Roche’s genetically engineered tissue plasminogen activator (t-PA) can be effective. That made Newell and his colleagues wonder: What if you added the gentle pulsating waves of the Ekos ultrasound probe to loosen up the clot, and help t-PA do a better job? Could that save lives, and precious time to help survivors avoid disabling brain damage?

No one had ever tried to combine ultrasound inside the brain with clot-busters before, but the results opened the eyes of a number of physicians last month at the American Heart Association’s International Stroke Conference in San Antonio, TX.

“We got a very enthusiastic response,” Newell says. The moderator of the session, Lee Schwamm, the vice chairman of neurology at Massachusetts General Hospital, said to the audience after Newell’s talk that the Ekos system is a potential “paradigm shift.”

It must be stated that this is all very preliminary. And before diving into the details that caught Schwamm’s eye, I should be clear about who stands to gain here and who doesn’t. About 80 percent of all strokes in the U.S. every year are what are known as ischemic strokes—which is totally different from the hemorrhagic variety. Ischemic strokes arise when … Next Page »

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