ó When Bruce Daily woke up after having lumbar surgery a
year ago, he realized he couldnít move the right side of his
took me a long while to figure out I wasnít gonna walk
again," he said. "I knew I was down."
69, had gone in for lumbar surgery at the University of Miami
hospital and had an ischemic stroke while under anesthesia. An
ischemic stroke results from an obstruction in a blood vessel
that blocks the blood from getting to the brain.
he was unconscious, he missed the four-to-five hour-window to
apply the tissue plasminogen activator, or tPA, the only
medication available to treat ischemic strokes. The medication
dissolves the clot, restoring blood flow to the brain.
while he missed that chance, he was right on time to meet Dr.
Dileep Yavagal, a neurosurgeon who practices at the University
of Miami and Jackson Memorial hospitals. Yavagal was enrolling
patients in RECOVER-stroke, a clinical trial treating recent
stroke patients with stem cells from their bone marrow and
applying them directly into the carotid artery, one of two
arteries that supply the neck and head with blood. Daily was
one of 47 patients nationwide who qualified for the study.
study is funded by Cytomedix, the company that developed the
technology to extract stem cells from bone marrow. The firm
chose Yavagal to lead a national blind study at the end of
enrolled 13 patients at the University of Miami/Jackson
Memorial Hospital, between the end of 2012 and January of
2014. So far, the initial three-month results have revealed
that the marrow cells are not doing any damage, and there was
no clear difference between those who received the cells and
those who didnít. The studyís one-year final results will
be revealed in January.
is severe need for developing treatment for ischemic stroke,
and stem cells are the most promising," said Yavagal,
whose own research is still in its initial phase, focusing on
using a healthy donorís bone marrow stem cells versus the
patientís own marrow.
the leading cause of adult disability in the United States,
and the No. 4 cause of death in the country, causes 130,000
deaths a year in the U.S., according to the Centers for
Disease Control and Prevention.
associate professor of clinical neurology and neurosurgery and
the director of interventional neurology at the University of
Miamiís Miller School of Medicine, said that restricted
mobility or loss of speech resulting from a moderate to severe
stroke can be devastating because patients often become
dependent on someone else for daily activities.
can really take your personhood away," he said, adding
that, besides physical therapy, there isnít any treatment to
help decrease the effects of a stroke.
believes his study, the first stroke treatment to be delivered
directly to the brain via the carotid artery, has the
potential to boost blood vessels affected by stroke.
the stem cells directly into the carotid artery as opposed to
intravenously, in which less than 3 percent reach the brain,
ensures that they donít become entrapped in the lungs and
carotid artery injection is not only something that is
minimally invasive, but also something that directly targets
the cells to go to where we know the injury is," he said.
explains that stem cells secrete chemicals, called growth
factors, that are able to rev up the bodyís repair mechanism
in the brain. They secrete anti-inflammatory chemicals and
prevent the death of cells affected by the stroke, getting
them back into a repair process.
would translate into the patientís handicap becoming
less," he said. "A person who is not able to move
because of weakness, that weakness would improve, and the
mobility would be increased."
has been able to start walking with the help of a walker since
his stroke, despite being someone with a long history of
surgeries and disabilities.
took a long time for me to use the walker, but I finally got
it," said Daily, who complains of lower back pain, which
could be a result of his lumbar surgery.
had four hip surgeries, two cervical spine surgeries, a knee
replacement and now the lumbar," he said. "Iíve
been cut and operated on for years."
the study is a blind study, meaning recipients donít know
whether they are receiving the marrow cells or a placebo, it
is hard to determine if Dailyís mobility improvement is
because of the stem cells or a placebo effect.
Ryan Pafford, the clinical research coordinator working with
Yavagal, says he believes Dailyís right side, the affected
side, has recovered well. He is still struggling with pain on
his left because of other injuries.
tells him his right side is stronger than his left, and
whether or not the stem cells gave him an extra push might be
hard to tell because of his many other injuries.
the waiting room on a recent day was Randy, Dailyís sister,
who cares for him.
66, said her "Bionic Man" brother, who was always
very active, has made a lot of progress since his stroke.
can now get up and down, out of cars, into bed," she
said. "Before he couldnít do anything."
remembers seeing him after the stroke with tears in his eyes,
which was unusual for a "tough kid" like him, but
she is hopeful he can recover and regain his independence.
it helps you or anybody else, thatíd be great," she
says as she strolled him out of the elevator and into the
parking lot, to which her brother replied, "Yup."
Yavagalís trial is only intended for people who have had
strokes in the previous two weeks or less, but he said his
ultimate goal is to target those patients with long-term
enrolling patients in another study, called Multistem, funded
by Athersys, which will test healthy donor stem cells being
applied intravenously within 48 hours of the stroke.
very optimistic that weíll have something for patients
soon," he said.
to recognize the symptoms of a stroke:
Drooping: Does one side of the face droop or is it numb? Ask
the person to smile. Is the personís smile uneven?
Weakness: Is one arm weak or numb? Ask the person to raise
both arms. Does one arm drift downward?
Speech Difficulty: Is speech slurred? Is the person unable to
speak or hard to understand? Ask the person to repeat a simple
sentence, like "The sky is blue." Is the sentence
to call 9-1-1. If someone shows any of these symptoms, even if
the symptoms go away, call 9-1-1 and get the person to the
hospital immediately. Check the time so youíll know when the
first symptoms appeared.