Circulatory Health magazine

A patch against a
stroke?
Every year, some 41,000 people in The
Netherlands have a stroke. This can be a
cerebral infarction or a brain
hemorrhage. A cerebral infarction is
caused by a clot that closes off a blood
vessel; a hemorrhage is caused by a
bursting blood vessel. Neurologist Bart
van der Worp: "Fortunately, new
treatments have greatly improved the
prognosis for a brain infarction in recent
years. Injecting an anticoagulant within
4.5 hours can prevent a lot of brain
damage. In addition, the clot can
sometimes be removed through a
catheter in the groin. The earlier you
intervene, the better the prognosis."
Stroke is a collective term for TIA,
cerebral infarction and brain hemorrhage.
Stroke is one of the four research themes of
the strategic theme Circulatory Health. We
study how we can improve treatment
methods to reduce or eliminate the
consequences of a stroke.
Patch
Unfortunately, only a small percentage of patients reach the
hospital in time to get the anticoagulant, and the clot can
only be removed in 10% of patients. "We are looking for
complementary treatment," says Bart. One of the options is a
nitroglycerin patch applied by ambulance staff.
We started a trial in April: MR ASAP.
Nitroglycerin has a vasodilating effect. Bart hopes that this
means that patients with a cerebral infarction reach the
hospital in a better condition. It also lowers the blood
pressure, which may help in the event of a brain hemorrhage.
Cheap and safe
One medication for two different causes of a stroke - that
almost sounds too good to be true. Bart thinks so too. "Two
small-scale British studies have shown that the results appear
to be favorable," he says. "We hope to be able to confirm this
with this larger study."
Nitroglycerin has been used as a medicine for over 100 years.
It opens the coronary arteries in case of an imminent heart
attack. Van der Worp: "It's also used in mining, to blast rock.
But that requires several kilos, compared to only milligrams
used in our research. In the clinic, nitroglycerin is cheap and
safe. The damage following a stroke is usually very debilitating.
We hope the patch limits the damage."
Circulatory Health Magazine 43