Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial
| Autor: | Gene Sung, Thomas Grobelny, Gary M. Nesbit, Ronald F. Budzik, Sidney Starkman, Jeffrey L. Saver, Marilyn M. Rymer, Wade S. Smith, Chelsea S. Kidwell, Y. Pierre Gobin, Randall T. Higashida, Helmi L. Lutsep, Michael P. Marks, Isaac E. Silverman |
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| Rok vydání: | 2005 |
| Předmět: |
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medicine.medical_specialty Solitaire Cryptographic Algorithm Time Factors medicine.medical_treatment Embolism Embolectomy Tissue plasminogen activator Brain Ischemia Multicenter trial medicine Humans Thrombolytic Therapy Prospective Studies Stroke Cerebral Hemorrhage Thrombectomy Advanced and Specialized Nursing Vascular disease Cerebral infarction business.industry Angiography Brain medicine.disease Surgery Treatment Outcome Anesthesia Tissue Plasminogen Activator Multivariate Analysis Reperfusion Regression Analysis Neurology (clinical) Cardiology and Cardiovascular Medicine business medicine.drug Follow-Up Studies |
| Zdroj: | Stroke. 36(7) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose— The only Food and Drug Administration (FDA)-approved treatment for acute ischemic stroke is tissue plasminogen activator (tPA) given intravenously within 3 hours of symptom onset. An alternative strategy for opening intracranial vessels during stroke is mechanical embolectomy, especially for patients ineligible for intravenous tPA. Methods— We investigated the safety and efficacy of a novel embolectomy device (Merci Retriever) to open occluded intracranial large vessels within 8 hours of the onset of stroke symptoms in a prospective, nonrandomized, multicenter trial. All patients were ineligible for intravenous tPA. Primary outcomes were recanalization and safety, and secondary outcomes were neurological outcome at 90 days in recanalized versus nonrecanalized patients. Results— Recanalization was achieved in 46% (69/151) of patients on intention to treat analysis, and in 48% (68/141) of patients in whom the device was deployed. This rate is significantly higher than that expected using an historical control of 18% ( P P P =0.01). Conclusions— A novel endovascular embolectomy device can significantly restore vascular patency during acute ischemic stroke within 8 hours of stroke symptom onset and provides an alternative intervention for patients who are otherwise ineligible for thrombolytics. |
| Databáze: | OpenAIRE |
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