Published February 11, 2015
Grabbing and removing a clot blocking blood flow to the brain, rather than just administering clot-busting drugs, dramatically improves the likelihood that patients will recover from a stroke, according to two highly-anticipated studies released on Wednesday.
The larger of the studies found that the procedure nearly halved the death rate from stroke.
Because three previous studies had failed to show a benefit from procedures employing clot-removing devices, the latest research should renew interest in the devices and are likely to change stroke treatment, experts said.
The two studies used devices made by Covidien, which was acquired by Medtronic PLC last month and helped pay for one of the trials. Stryker Corp and privately-held Penumbra Inc also manufacture devices approved for clot removal.
The research echoes a large Dutch study published in December, called MR CLEAN, that also found a benefit from fishing a clot out of an artery. Taken together, they offer "a really persuasive signal that we're on to something," said Dr. Patrick Lyden, director of the Stroke Program at Cedars-Sinai Medical Center in Los Angeles, who was not involved in the studies.
Lyden, who helped develop clot-busting drugs, said he had been skeptical of the devices, but called the latest results "tremendous," adding, "it's a whole new world for us. Medical centers are going to have to gear up and be able to do this treatment quickly."
The two studies were reported at the American Heart Association/American Stroke Association International Stroke Conference in Nashville and released in summary form by the New England Journal of Medicine.
In one trial, called ESCAPE and conducted at 22 centers worldwide, 53 percent of 120 patients who had clot removal via a tube fed into a blood vessel of the brain were functionally independent 90 days later. Of the 118 who received only the standard clot-busting drug, 29 percent were.
While 19 percent of patients receiving drugs alone died within three months, only 10.4 percent of those whose clots were removed died.
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After stroke, clot removal saves brain function, studies say