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:9/1/2020)... ... September 01, 2020 , ... Board ... in Glendale. While the office will be the first to bear her name, ... buttock augmentation (Brazilian butt lift), as well as rhinoplasty, facial rejuvenation, and many ...
(Date:9/1/2020)... ... , ... As fall and winter swiftly approach and many businesses cut costs ... this time to expand and grow into a full-fledged natural health clinic over the ... be relaunching its brand new website, expanding its services menu and has recruited top-tier ...
(Date:8/31/2020)... ... 2020 , ... The Lymphoma Research Foundation (LRF) ... and serving the lymphoma community through a comprehensive series of education programs, outreach ... Awareness Month (BCAM) and its international Light it Red for Lymphoma ...
(Date:8/31/2020)... ... 31, 2020 , ... Want to get moving, break up your routine, and ... is thrilled to launch its fourth annual STEPtember campaign in the United States to ... everyone wherever they are at this moment — encouraging people to move in the ...
(Date:8/31/2020)... ... August 31, 2020 , ... Smile Brands Inc., ... in the United States, today announced the grand opening of another affiliated ... Patients will enjoy convenient hours, a comfortable office, and full-service care at the ...
Breaking Medicine News(10 mins):
(Date:9/1/2020)... ... September 01, 2020 , ... September is National Ovarian Cancer Awareness Month. ... than any other cancer of the female reproductive system. The American Cancer Society ... about 14,000 women will die from this disease. Throughout the month of September, ...
(Date:8/31/2020)... ... August 31, 2020 , ... If you live in New York City you will always ... makes sense, it’s the law of supply and demand, but are plastic surgeons in New ... significant percentage of their patients that make the four-hour trip to have expert aesthetic treatments ...
(Date:8/31/2020)... ... , ... Cloudticity announced today that Network Products Guide, industry’s ... the 15th Annual 2020 Network PG’s IT World Awards®. , The IT World ... Guide honoring achievements of world’s best in organizational performance, product and service innovations, ...
Breaking Medicine Technology: