New research studies add to evidence that mechanical clot retrieval can improve ischaemic stroke outcomes

Friday 17 April 2015

About 85% of all strokes are caused by a blood clot blocking an artery in the brain.

Mechanical clot retrieval (thrombectomy) is a procedure by which the blood clot causing a stroke is pulled out of the brain, typically using a device inserted into an artery called a 'stent retriever'.

Two new research studies on thrombectomy were published today in The New England Journal of medicine, called SWIFT PRIME and REVASCAT.

The results of SWIFT PRIME had first been shared at the International Stroke Conference (ISC) 2015, alongside similar findings from three other trials called MR CLEAN, EXTEND-IA and ESCAPE, all of which were published in the New England Journal of Medicine.

The results of the trials were all positive, and suggested that early treatment with thrombectomy could reduce the disability caused by strokes that occur in the main, large arteries of the brain. Read further information on the presentations for these four trials at ISC 2015.

However, today was the first time that the final results of REVASCAT were presented, which took place at the European Stroke Organisation Conference (ESOC) in Glasgow (running between 17 and 19 April 2015).  REVASCAT was stopped early in light of the positive findings from the other trials.

Dr Shamim Quadir, Research Communications Manager at the Stroke Association, said: “Currently, thrombolysis is the only proven treatment which can limit the damage caused by acute ischaemic stroke, the type of stroke caused by a blockage of an artery in the brain by a blood clot. However, it must be administered within 4.5 hours of stroke onset, and benefits around one in seven people treated. 

“Thrombectomy is a potential treatment where the blood clot causing the stroke is pulled out of the brain, typically using a device inserted into an artery called a 'stent retriever'.

“The latest findings from the REVASCAT trial add to a growing body of evidence (from the studies MR  CLEAN, ESCAPE, EXTEND-IA and SWIFT PRIME) suggesting that thrombectomy can be an effective form of treatment which decreases the disability caused by blood clots in large arteries of the brain. The results also suggest that thrombectomy can be effectively and safely used in addition to thrombolysis, and can be given beyond the 4.5 hour window.

“This is a very exciting area of stroke research. We hope the findings of these trials will help us find new and innovative ways to ensure more people make their best possible recovery from stroke.”

REVASCAT

What was the study's purpose?

To test the effectiveness and safety of thrombectomy for ischaemic strokes in the main, large arteries of the brain. 

What did the study involve?

It used brain scans to select 206 appropriate, ischaemic stroke patients. These patients had either received thrombolysis within 4.5 hours of stroke (and which had not, within 30 minutes of giving it, restored the blood flow blocked by the clot), or were patients for which thrombolysis was contraindicated (advised against). Half (103) of these patients were assigned to a group to receive thrombectomy with a mechanical (stent retriever) device called SOLITAIRE FR, administered within eight hours after stroke. The other half of patients did not receive thrombectomy.

What did the study find?

It found that the additon of thrombectomy (with the SOLITAIRE FR device) to best medical treatment reduced the severity of disability and increased the rates of improved functional independence of patients three months after stroke.

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