Clot-retrieving devices better than clot dissolving drugs, study reveals

18 Dec 2014

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An article published yesterday in The New England Journal of Medicine proved the efficiency of intra-arterial treatments as against clot-dissolving drugs in the battle against strokes, www.wallstreetotc.com reported. The conclusions would benefit 125,000 patients in the US 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 conducted on 500 Dutch patients, all of whom suffered from strokes induced by blockage in the large forward arteries of the brain.
 
The scientists found out that it was preferable to treat embolus in large vessels using intra-arterial devices (the procedure is called embolectomy), which gave better results in comparison to treatments based on clot-dissolving (lytic) drugs alone (usually tPA).
 
Dr Jeffrey Saver, a co-director of the University of California Los Angeles Stroke Center, said such devices had been used earlier, but none of them proved to be better than the classical drug treatment. According to Sidney Starkman the other co-director of the UCLA Stroke Center, who was involved in previous stroke-related studies, up until now tPA treatment was superior to the one based on clot-removing devices. However, only a third of the cases respond to such drugs.
 
Catching the clot and fishing it out of the blocked artery to reopen it made a big difference in outcome, The Washington Post reported Saver as saying. Though the devices to retrieve clots had been around for a while, until now, ''we hadn't had a clinical trial showing that they made patients better.''
 
Ninety days following their stroke, 32.6 per cent of patients whose treatment included going into a brain artery to remove a clot achieved functional independence, as against 19.1 per cent who received the usual clot-dissolving drugs, the study showed.

According to study co-author Albert J Yoo, director of acute stroke intervention at Boston's Massachusetts General Hospital, it was about the sickest stroke patients, the ones with blockages of their main arteries leading to the brain and these patients accounted for the majority of disability and death related to stroke.
 
According to Saver, who was not involved in the study, the findings should give people an even stronger reason to get someone to the hospital as quickly as possible if they demonstrated stroke symptoms such as facial drooping, arm weakness or speech difficulties.

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