Navigation Links
For stroke patients, mechanical clot removal delivers no advantage over standard care
Date:2/8/2013

WASHINGTON The first randomized controlled study to evaluate a procedure that removes blood clots in the brain from patients experiencing severe strokes finds it delivers no better outcomes than non-invasive standard medications. In addition, the study found imaging techniques were not helpful in identifying patients who potentially would benefit most from clot removal.

The study, led by a Georgetown University Medical Center researcher, was published online today in the New England Journal of Medicine and simultaneously presented at the International Stroke Conference in Honolulu, Hawaii.

"The hope was, and to some degree still is, that if you pull out the clot within a certain period of time and there is salvageable brain tissue, there will be better outcomes," said lead researcher Chelsea Kidwell, M.D., professor of neurology and director of the Stroke Center at Georgetown University Medical Center.

Currently, the only proven effective treatment for a stroke caused by a blood clot (ischemic) is tPA (tissue plasminogen activator). The treatment, administered in the hospital, must be given within the first few hours after stroke symptoms appear. For patients who don't meet the timeline for treatment or whose clots do not respond to tPA, an interventional procedure to remove the is another option.

The study, named MR RESCUE (Mechanical Retrieval and REcanalization of Stroke Clots Using Embolectomy), was conducted at 22 institutions in the U.S. The trial evaluated outcomes in 118 patients at an average age of 65.5 who had suffered a severe ischemic stroke in one of the large blood vessels carrying blood to the front of the brain (the most common location for this type of stroke).

By removing the clot within the first eight hours of having the stroke, researchers hypothesized that the procedure would restore blood flow to the affected area of the brain. Prior to conducting the procedure, the patients received an array of MRI or CT scans, including a blood flow study, to help identify those with viable brain tissue who presumably would benefit if the clot was removed and blood flow restored.

After imaging studies were processed using study-specific software to determine if substantial salvageable brain tissue was present, the patients were randomized to receive either standard medical treatment (aspirin or other medicine) or clot removal with a special device. Patients who received tPA were allowed to enroll in the study if the treatment failed. Tools used to remove the clot included the MERCI Retriever (a tiny corkscrew-like device) or the Penumbra System (an aspiration device).

Researchers found no greater overall benefit in patients who had their clot removed compared to standard medicines. More specifically:

  • The level of disability 90 days after stroke was no different in patients who received medical care or clot removal.
  • The rates of death (21 percent) and symptomatic brain bleeds (4 percent) were no different in the two treatment groups.
  • Response to clot removal was no better in the 58 percent of patients with a favorable imaging pattern that suggested salvageable brain tissue.

Kidwell says these findings may not apply to the newer clot removal tools that can open vessels better and faster. "The safety data for these tools examined in this study are encouraging, which is important as we move forward to evaluate newer and possibly better devices," she said


'/>"/>

Contact: Karen Mallet
km463@georgetown.edu
Georgetown University Medical Center
Source:Eurekalert

Related medicine news :

1. Imaging acute ischemic stroke patients brains did not lead to improved outcomes
2. One in Every 12 Stroke Survivors Contemplates Suicide, Study Finds
3. Southern Diet Might Explain the Stroke Belt
4. Docs, Families May Underestimate Patients Odds After Some Strokes: Study
5. Surgical Delivery of Drug Shows Promise Against Bleeding Stroke
6. Stroke During Childhood May Raise Risk for Epilepsy, Study Says
7. US Drug Watchdog Now Urges Users of Yaz Yasmin Birth Control Pills and Had a Heart Attack or Stroke As Far Back As 2005 to Call The Johnson Law Group-Nationwide
8. Self-Esteem, Optimism Help When Caring for Spouse After Stroke
9. Clot-Buster Drug May Still Be Best Stroke Treatment
10. Smoking Pot May Raise Stroke Risk in Young Adults
11. Tai Chi Might Help Stroke Survivors Avoid Falls
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/4/2016)... ... December 02, 2016 , ... Metabolic Code ... to nutraceuticals and help doctors more efficiently manage their practice. Power2Practice is ... software platform for Integrative and Functional Medicine. , The Metabolic Code platform ...
(Date:12/4/2016)... ... December 03, 2016 , ... While James Earl Jones is known ... for in a show called "Front Page". One of the forthcoming episodes examines mammogram ... rates have plummeted in large part due to early detection. Like any other disease, ...
(Date:12/4/2016)... ... December 04, 2016 , ... ... new attractive animation styles with unique displacement design elements," said Christina Austin - ... third designs. Choose from a variety of design styles that include both left ...
(Date:12/4/2016)... (PRWEB) , ... December 04, 2016 , ... Responsible dental ... One must brush properly to achieve optimal results. This important necessity inspired an inventor ... need for a way to ensure that people break or avoid bad techniques of ...
(Date:12/2/2016)... Phoenix (PRWEB) , ... December 02, 2016 , ... ... statewide documentary on the perils of heroin that was watched live by 1 ... national Alfred I. duPont-Columbia University Award. , ASU students at the Walter Cronkite ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... The U.S. Food and Drug Administration today ... the risk of cardiovascular death in adult patients with ... "Cardiovascular disease is a leading cause of death ... Jean-Marc Guettier , M.D., C.M., director of the Division ... Drug Evaluation and Research. "Availability of antidiabetes therapies that ...
(Date:12/2/2016)... in the ECG Cables And ECG Leadwires Market owing to ... devices. On the other hand, the Asia-Pacific ... rate during the forecast period. The market players ... plc ( Ireland ), Koninklijke Philips N.V. ( ... ( China ), held major share of the ...
(Date:12/2/2016)... 2016 According to a ... by Product (Instruments, Reagents, Software), Technology (Immunoassay, Clinical ... Nephrology, Infectious Diseases) - Forecast to 2021" published ... USD 60.22 Billion in 2016. This market is ... during the forecast period (2016-2021) to reach USD ...
Breaking Medicine Technology: