Mechanical Thrombectomy – new treatment for severe cases of stroke
Mechanical Thrombectomy ( Stentrievers ) -new treatment for severe cases of stroke
* In the US, a new cutting edge treatment is being evaluated to treat disabling strokes. It uses tiny devices to snag large clots from a blocked artery within the brain.
The clot-removal devices are wire cages called stent retrievers, or “stentrievers” .
* The main treatment for long has been tissue plasminogen activator, or tPA — a clot-busting drug approved by the Food and Drug Administration in 1996 that must be given intravenously within 4.5 hours to be effective. But for people with blood clots in larger arteries, tPA often does not dissolve them completely.
* Now, five studies, all published in the New England Journal of Medicine in the past six months, offer the first evidence in 20 years that a new treatment can help people who are having a stroke, the world’s No. 2 cause of death and a leading cause of disability.
* The procedure, called mechanical thrombectomy, should be done within six hours of acute stroke symptoms, and only after the patient receives tPA. To remove the clot, doctors thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot, allowing doctors to remove the stent with the trapped clot. Special suction tubes may also be used.
* Stent retrievers are already being used at hospitals across the United States, including all 90 comprehensive stroke centers and some of the more than 1,000 primary stroke centers certified by the AHA/American Stroke Association and the Joint Commission, a nonprofit that accredits hospitals.
* The FDA cleared two stent-retrieval devices in 2012: Solitaire, made by Minneapolis-based Medtronic, and Trevo, made by Stryker Corporation of Kalamazoo, Michigan. These newer clot-snagging stents are safer and more effective than older devices that resembled a corkscrew.
* Even so, the procedure does not work for every stroke patient, and the results can vary.
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