An article published today (Dec.17) in The New England Journal of Medicine proved the efficiency of intra-arterial treatments in comparison to clot-dissolving drugs in the battle against strokes. The conclusions could affect up to 125,000 patients in the U.S. and 90,000 in Europe annually.
This trial study, known as Mr.Clean (Multicenter Randomised Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands), was applied to 500 Dutch patients. All of them were suffering from strokes induced by blockage in the large forward arteries of the brain.
The scientists found out that it is better to treat embolus in large vessels using intra-arterial devices (the procedure is called embolectomy). This method had better results in comparison to treatments based on clot-dissolving (lytic) drugs alone (usually tPA).
According to Dr. Jeffrey Saver, a co-director of the University of California Los Angeles Stroke Center, such devices had been studied in the past, but none of them proved to be better than the classical drug treatment. Dr.Sidney Starkman the other co-director of the UCLA Stroke Center, who was involved in previous stroke-related studies, also stated that up until now tPA treatment was superior to the one based on clot-removing devices. However, only a third of the cases respond such drugs.
The study used, among others, the Stryker’s Trevo® Retriever. The device is inserted into the patient’s femoral artery residing in one’s leg and then guided towards the vessel with the clot. After grabbing the embolus, the retriever is then slowly removed from the site, being guided back to the initial site and then withdrawn from the body. All the patients had to be treated within 6 hours of onset and the stroke had to be caused by a clot situated in the forward-most arteries of their brain.
Wade Smith, MD, PhD a Professor of Neurology at The University of California, San Francisco described the Stryker’s Trevo® Retriever as a “substantial improvement” in comparison to previous decives, referring to the trial’s results.
The study showed that 90 days after suffering from a stroke, 32.6 % out of the patients treated with clot-removing devices gained functional independence. The same result was seen in only 19.1 % out of those who received the classic treatment based on clot-dissolving drugs.
These findings should be an additional motive for people to rush those suffering from stroke to the hospital as quickly as possible. Stroke symptoms include facial drooping, weakness in arms and impediment in speech.
Image Source: Cardiovascular News
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