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Imaging acute ischemic stroke patients' brains did not lead to improved outcomes
Date:2/8/2013

involves threading a special catheter through an artery in the groin up to the site of a clot in a brain artery, then removing the blockage.

"Despite a lack of evidence showing that these clot-removal devices improve outcomes, they are already widely used in patients who are not able to get to the hospital in time to receive t-PA," said Walter J. Koroshetz, M.D., deputy director of NINDS. "Though some patients have had dramatic improvements with clot removal, it has not been shown effective in this or another larger study, the Interventional Management of Stroke (IMS III), which was halted early because it did not find the procedure to be of significant benefit."

"The majority of patients were not eligible to receive intravenous t-PA, the only drug approved by the Food and Drug Administration for the treatment of stroke, because they arrived at the hospital too late for t-PA to be effective," said one of the primary investigators, Chelsea Kidwell, M.D., of Georgetown University Medical Center in Washington, D.C. As brain cells are dying continuously in the minutes and hours after stroke, the earlier that treatment is given the greater the likelihood of a good outcome for the patient.

The patients with the presumed favorable imaging findings had the same level of disability at 90 days whether or not they had undergone the clot-removal procedure or had received standard therapy. The researchers hypothesized that the lack of a treatment effect may reflect the fact that these patients had enough blood flow to the brain from secondary sources to support the brain tissue until spontaneous reperfusion occurred. Patients without the favorable imaging findings did not benefit from the clot-removal procedure.

However, the results of MR RESCUE are not consistent with the conclusions of a separate NINDS-funded observational study called DEFUSE-2 th
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Contact: Kathryn DeMott
nindspressteam@ninds.nih.gov
301-496-5751
NIH/National Institute of Neurological Disorders and Stroke
Source:Eurekalert

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