When a person has a stroke, often the cause is a clot in one of the blood vessels in the brain. The clot blocks the flow of blood and the brain starvation that results can lead to paralysis and even death. Two recent studies which were published in The Lancet to coincide with a European Society of Cardiology meeting in Munich, suggest that nets may be the way to go when clot busting drugs are not an option.
The first of the studies published on August 26, 2012 is entitled “Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial.”
According to one of the researchers on the project Prof Jeffrey Saver from the University of California, Los Angeles, “Clot-busting drugs only partially reopen 40% of large blocked arteries. These devices partially reopen 70-90% of large blocked arteries.
“Second, these devices can be used in patients in whom it is not safe to give ‘clot busting’ drugs, such as patients taking anticoagulant medications, patients who had recent surgery, and patients who are between 4.5 to eight hours after stroke onset.”
In this study, which took place at 17 locations in the United States and one in France, patients were assigned to two different groups, one which used the Solitaire Flow Restoration Device which is a unique self-expanding stent retriever and the other which used the more traditional Merci Retrival System which involves inserting a tube through a vein in the groin. To be included in the study group patients must have suffered from an acute ischaemic stroke which resulted in severe neurological deficits. Their condition must also be treatable by a clot retrieval system and time was of the essence with treatment coming within 8 hours of the onset of the stroke.
The study was conducted between February 2010 and February 2011 with a total of 113 patients included. Of those 113, 55 were treated with the Solitaire and 58 were treated with the Merci method. The results were heavily in favor of the Solitaire group. After three month, the patients in the Solitaire group had 25% better brain function and there were also fewer deaths in the Solitaire group.
A second study of 178 patients showed almost double the ability to live independently, after the procedure.
Dr. Philip Gorelick, from Michigan State University, in a comment in The Lancet stated “major steps forward in the successful treatment of acute ischaemic stroke, and pave the way for new treatment options”. In his study 178 patients
In response to the release of the results of the studies, Dr. Clare Walton of the Stroke Association, “Clot retrieval devices have the potential to be used with more stroke patients and are better at removing blood clots than clot-busting drugs. “We are very excited about this potential new treatment and look forward to further developments.”