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

eived 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


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

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