VIable

NDHI
NAT IONAL DIALOGUE FOR
Healthcare Innovation
Making Healthcare Better
Through Innovation in Stroke
Patient Management
Organization Overview
Stryker is a leading global medical technology company
that is driven to work together with their customers to
make healthcare better.
Background
An ischemic stroke occurs when a blood clot or other
substance such as plaque, a fatty material, blocks the
blood flow through an artery in the brain. Arteries carry
essential blood, oxygen and nutrients from the heart
to the brain. When the brain is deprived of blood and
oxygen, its cells begin to die and the patient begins
to lose ability to complete the activities those cells
managed. Depending on the severity of the stroke
and the area of the brain affected, permanent loss of
brain function or patient death may occur. Ischemic
stroke affects 650,000 Americans annually and is the
number five cause of death. There are over 7 million
stroke survivors in the United States, two thirds of
whom are living with moderate to severe disability.
30% are unable to walk without assistance, 50% have
some level of partial paralysis and 19% have trouble
finding words when they speak.
About one third of all ischemic strokes, or roughly
215,000, involve blockage of a large blood vessel, known
as a large-vessel occlusion (LVO). LVOs can be the
most devastating and most difficult to successfully treat
because they cut off blood flow to such large portions
of the brain. During an LVO stroke, 1.9 million neurons,
14 billion synapses and 12km of myelinated fibers
are destroyed every minute. As the U.S. population
continues to age, stroke will become an even more
common disease and an increasing cost burden on
the healthcare system.
In stroke, evidence shows that the more quickly a
medical intervention is administered, the better the
outcome is for the patient. This concept is referred to by
researchers and clinicians as “time is brain,” meaning
the less time to treatment the less brain function is lost.
Stryker manufactures a product called the Trevo ®
Retriever which physicians use to capture and remove
a clot, restoring blood flow to a patient’s brain, during
a procedure called thrombectomy. Trevo ® is cleared
by the FDA as an initial therapy to reduce disability
in stroke patients. Trevo’s disability indication is for
LVO patients also receiving IV lytics who can have a
thrombectomy within 6 hours of stroke onset. Trevo
also has a mechanical indication allowing it to be used
for clot removal in patients who are ineligible for or
have failed IV lytic therapy up to 8 hours post stroke
onset. Trevo ® is the first therapy in 20 Years to be
declared a front-line treatment to reduce disability
in ischemic stroke.
In spite of overwhelming clinical evidence, ASA guidelines
and FDA indications all supporting thrombectomy as
a primary treatment of LVO stroke, only about 1 in 10
eligible patients receives thrombectomy in the United
States. There are two major infrastructure-related
barriers to timely and effective stroke treatment today:
1.) Scarcity of hospitals: Fewer than 600 hospitals in
the United States have the ability to perform stroke
thrombectomy. With half of stroke patients transporting
themselves to hospitals instead of calling 9-1-1, most
patients begin their care journey at a hospital that
cannot provide the standard of care treatment for LVO.
This necessitates a rapid, efficient system of patient
triage and transfer between hospitals.
An Initiative of the
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Making Healthcare Better Through Innovation in Stroke Patient Management