New Concept in Stroke Therapy

Prof. Lawrence K.S. Wong, professor of Medicine and Therapeutics, demonstrating the use of ECP

Stroke is a major cause of death and disability in Hong Kong. Every year, more than 20,000 patients are admitted to hospital for stroke treatment. Ischemic stroke is caused by a blockage of blood flow to the brain. Apart from physiotherapy and occupational therapy, no other treatment can enhance neurological recovery.

External counterpulsation (ECP) can improve endothelial function and enhance blood flow to the heart, brain and kidney but there have been very few good clinical studies in this field. The Department of Medicine and Therapeutics and the S.H. Ho Cardiovascular Disease and Stroke Centre at The Chinese University has recently completed a pilot study on the use of ECP to access the effect of ECP on brain blood flow in stroke patients with relevant large artery occlusive disease.

50 stroke patients (32 men and 18 women) at the Prince of Wales Hospital have been studied since 2004.

After seven weeks of ECP, patients who received immediate therapy had an increase of 49 ml/min blood flow when compared to 28 ml/min in the group receiving late therapy. The stroke deficit also improved more quickly in the early group. By 14 weeks, none of the patients in the early group had severe disability versus 24% of those in the late group. Besides, repeated strokes occurred in only one patient in the early group and four in the other.

ECP appears to be safe and effective for increasing brain blood flow and enhancing neurological recovery after stroke. An international clinical trial is being planned in many countries in Asia to confirm this encouraging result.