New device performs better than old for removing blood clots
February 3, 2012 in Cardiology
An experimental blood clot-removing device outperformed the FDA-approved MERCI; retriever device, according to late-breaking science presented at the American Stroke Association's 2012 International Stroke Conference.
The SOLITAIRE; Flow Restoration Device is a self-expanding stent-based design that mechanically removes blood clots from blocked vessels after a stroke. After insertion into the clot using a thin tube, or catheter, the device traps the clot then both device and clot are removed, restoring blood flow. The MERCI retriever uses a tiny corkscrew, guided by a balloon-tipped wire, to snare and remove the blood clot.
In the Solitaire With the Intention for Thrombectomy (SWIFT) trial, the first U.S. clinical trial to compare the two devices, 113 stroke patients at 18 hospitals were randomly assigned to undergo clot removal with either device within eight hours of stroke onset between Feb. 2010-Feb. 2011.
The trial was ended at the suggestion of a safety monitoring committee nearly a year earlier than planned due to significantly better outcomes with the new device. The experimental device opened blocked vessels without causing symptomatic intracranial hemorrhage in 61 percent of patients. The currently approved device had the same result in 24 percent of cases - a statistically significant difference, said Jeffrey L. Saver, M.D., lead author of the study, professor of neurology and director of the Stroke Center in the Geffen School of Medicine at the University of California in Los Angeles.
The use of the new device also led to better survival three months after stroke. There was a 17.2 percent mortality rate with the new device versus 38.2 percent with the older one.
Stroke caused by a blood clot blocking a blood vessel supplying the brain is the most common type of stroke, accounting for about 87 percent of all strokes. The FDA-approved treatment for stroke with the most robust body of evidence is use of a clot-busting drug, but the drug must be given within 4.5 hours of symptom onset, and more quickly in older patients. When clot-busting drugs cannot be used or are ineffective, the clot can sometimes be mechanically removed, during or even after the 4.5 hours. The study didn't compare mechanical clot removal to drug treatment.
Although not yet approved in the United States, the new device is approved in Europe.
Other specific findings - all of which were statistically significant - were:
Two percent of SOLITAIRE-treated patients had symptoms of bleeding in the brain compared to 11 percent of MERCI patients.
At the 90-day follow-up, overall adverse event rates, including bleeding in the brain, were similar for the two devices.
Fifty-eight percent of SOLITAIRE-treated patients had good mental/motor functioning at 90 days compared to 33 percent of MERCI patients.
The SOLITAIRE device also opened more vessels when used as the first treatment approach, necessitating fewer subsequent attempts with other devices or drugs.
Patients' average age was 67 years and 68 percent were male. Forty percent had not improved with standard clot-busting medication prior to the study, while the remainder had not received it.
The time from the start of symptoms to start of the clot retriever treatment was on average 4.9 hours for SOLITAIRE and 5.3 hours for MERCI. The study results account for this time difference.
"This heralds a new era in acute stroke care," said Saver. "We're going from our first generation of recanalization procedures, which were only moderately good in reopening target arteries, to now having a highly effective recanalization device. This really is a game-changing result."
Provided by
American Heart Association
-
Clot-busting drugs appear safe for treating 'wake-up' stroke patients
Feb 01, 2012 |
not rated yet |
0
-
Use of clot busters for stroke increased from 2005 to 2009, but still low
Jun 02, 2011 |
not rated yet |
0
-
Intracranial stenting, injecting clot-busting drugs directly to brain
Feb 25, 2010 |
not rated yet |
0
-
Clot-busting drugs improve diabetic stroke patients' prospects, study reveals
Nov 16, 2011 |
not rated yet |
0
-
Cholesterol drugs may improve blood flow after stroke
Apr 26, 2011 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Enthalpy of reaction
4 hours ago
-
Harmonic oscillation problem -Dancing pot
5 hours ago
-
Ultracapacitor to power electromagnet?
5 hours ago
-
Confusion in Electro Statics
6 hours ago
-
simple gravity question
7 hours ago
-
I need help understanding the Fourier components of a square wave
9 hours ago
- More from Physics Forums - Classical Physics
More news stories
Which women should be screened for high cholesterol?
National guidelines recommend that at-risk women be screened for elevated cholesterol levels to reduce their chances of developing cardiovascular disease. But who is 'at risk?' The results of a study by investigators ...
Cardiology
41 minutes ago |
not rated yet |
0
Atherosclerotic disease heredity mapped in nationwide study
Researchers at Lund University in Sweden have mapped the significance of heredity for common forms of atherosclerotic disease. No studies have previously examined whether different forms of the disease share heredity.
Cardiology
2 hours ago |
not rated yet |
0
Study finds improved CPR quality saves lives
(Medical Xpress)—Life-saving CPR has been a foundation of emergency medicine for more than a half century. But researchers at the University of Arizona College of Medicine-Phoenix are continuing to refine the procedure, ...
Cardiology
3 hours ago |
not rated yet |
0
Genetic screening could reveal hidden high risk for coronary heart disease
Finnish researchers have shown that genetic marker information can improve risk evaluation of coronary heart disease. The study comprised over 24,000 Finnish subjects and was led by Professor Samuli Ripatti. The results revealed ...
Cardiology
6 hours ago |
not rated yet |
0
Free fatty acids linked to cardiac risk in late adulthood
(HealthDay)—Blood levels of free fatty acids are associated with insulin resistance during young adulthood and cardiovascular risk factors in later adulthood, according to a study published online May 13 ...
Cardiology
May 17, 2013 |
not rated yet |
0
|
New study finds blind people have the potential to use their 'inner bat' to locate objects
New research from the University of Southampton has shown that blind and visually impaired people have the potential to use echolocation, similar to that used by bats and dolphins, to determine the location of an object.
Researchers find far-reaching, microvascular damage in uninjured side of brain after stroke
While the effects of acute stroke have been widely studied, brain damage during the subacute phase of stroke has been a neglected area of research. Now, a new study by the University of South Florida reports that within a ...
Breakup of physician, drug company relationship could improve health care, cut cost
A new report suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, ...
One in ten teens using 'study drugs,' but parents aren't paying attention
As high schoolers prepare for final exams, teens nationwide may be tempted to use a "study drug"—a prescription stimulant or amphetamine—to gain an academic edge. But a new University of Michigan poll shows only one in ...
Food laboratory accuracy remains a concern
Food microbiology laboratories continue to submit false negative results and false positive results on a routine basis. A retrospective study of nearly 40,000 proficiency test results over the past 14 years, presented today ...
Study supports 'aggressive' treatment for posterior fossa hematoma in newborns
Posterior fossa subdural hematoma (PFSDH) is a serious and rare condition in newborns, generally occurring after difficult deliveries. But with appropriate treatment, there's an excellent chance of good long-term outcomes ...