Study: Thrombectomy Effective for Clot Removal in Large-vessel Strokes

Thrombectomy and other intra-arterial treatments shone in the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial, according to an article on MedPageToday.com. The trial showed that thrombectomy improved functional outcomes in severe stroke with proximal large-vessel occlusion treated up to six hours after stroke onset. Good functional outcome at three months was 67 percent more likely in the intra-arterial treatment group after adjustment for other factors than with usual care alone, researchers discovered. MR CLEAN required all patients to be able to initiate intra-arterial treatment within six hours of onset of a stroke with occlusion of the distal intracranial carotid artery, middle cerebral artery, or anterior cerebral artery proven by CT, MRI or digital-subtraction angiography. Of the 500 patients at 16 medical centers in the Netherlands randomized to treatment with intra-arterial treatment plus usual care or usual care alone, almost 90 percent received intravenous thrombolysis first. The study, published online in the New England Journal of Medicine, reported that survival with little or no disability as measured by a modified Rankin score of no more than 2 occurred in 32.6 percent of patients who got intra-arterial treatment, compared with 19.1 percent who got medical treatment alone. While some proponents, such as the Society of NeuroInterventional Surgery, applaud the study and its strategy, others caution that other trials are needed, given previous thrombectomy trial results. To learn more about the study, click here.