Stents Show Promise in Stroke Patients
December 18, 2014
Scientists have discovered that using a stent-retrieving device to remove blood clots from the brain can significantly help patients recover from stroke. According to The New York Times, the technology may be a game changer for patients suffering from severe strokes, who have had few treatment options for decades.
The research, published in the New England Journal of Medicine, found that using the stent thrombectomy device for up to six hours after a stroke benefited patients more than the clot-busting drugs commonly used by physicians.
In the procedure, the stent attached to a catheter is threaded into an artery in the leg and then pushed into the clotted artery in the brain. The stent pierces the clot and is then expanded, enabling the physician to then pull it out--similar to how the Fogarty catheter works, albeit with a stent rather than a balloon.
"This is really exciting, a landmark finding that we have been buzzing about," said Stephan A. Mayer, MD, a neurologist and the director of the Institute for Critical Care Medicine at the Icahn School of Medicine at Mt. Sinai in New York, told the Wall Street Journal. "It reduces by half the number of people bed-bound" and decreases "by 40% the people who need another human being to help them walk." Mayer was not involved in the study, the newspaper said.
Researchers enrolled 500 patients at 16 medical centers in the Netherlands--assigning 233 to intraarterial treatment and 267 to the usual care. They used retrievable stents in 190 of the 233 patients (81.5%) assigned to intraarterial treatment, and found that the treatment was "effective and safe," the medical journal reported.
The MR CLEAN trial (Multicenter Randomised Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands)was the first to achieve a strong positive outcome using stent-retrievers, according to the Wall Street Journal article. Previous research failed to show positive results, and some insurers refuse to pay for the devices, the newspaper said.
Stryker and Covidien crowed about the researchers' use of their stent retrievers.
Covidien's Solitaire device thrombectomy procedure uses a microsized catheter to access arteries in the brain affected by stroke through an incision in the leg, the company said in a statement. Once delivered, the Solitaire device helps to immediately restore blood flow and remove the blood clots causing the stroke, the company said.
Stryker's Trevo Retrieverwas also used in the study, that company said in a statement. The Trevo ProVue Retriever is the only such device on the market that allows physicians to visualize blood clot interaction, according to Mark Paul, president of Stryker Neurovascular. Stryker also recently won the Prix Galien USA award for Best Medical Technology of 2014 for the Trevo device, the company said in a previous statement.
Nancy Crotti is a contributor to Qmed and MPMN.
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