Mr Clean

Medicine changes incredibly quickly. Since graduating medical school five years ago, our therapeutics have evolved dramatically; even in the last year, I'm seeing noticeable changes in the way we treat major diseases. One great example is stroke therapy. When I started medical school, I was taught that ischemic strokes are treated with medications and only in very limited circumstances (within three hours of the stroke onset). In my clinical years, I heard about endovascular therapies where an interventional radiologist or neurologist goes in with a cannula to try to remove a clot, but at that time, it was only for strokes in particularly troubling territories (basilar artery, posterior circulation). Perhaps it was around that time when studies helped relax the tPA window to 4.5 hours.

In the last year or so, we've been seeing way more patients going to the catheterization lab for interventional endovascular therapies. Newer devices such as the one shown above give a proceduralist more ability to do clot-directed interventions. A host of trials including the recent MR CLEAN trial have supported the use of IR-based therapies like this. Hopefully we are reducing the morbidity of strokes, which are so common and can be so devastating. But it's also increasing the cost of medical care. I can't imagine where things will be five more years from now.

Image of the mechanical thrombectomy device is shown under Creative Commons Attribution Share-Alike License, from Wikipedia.