Manually removing blood clots after a stroke is not a new concept. In fact, several studies have already been done exploring its benefits. However, it is only now that a study in the Netherlands was able to precisely show that patients feel better after the procedure.
Called MR CLEAN, the study involved 500 stroke patients with a blockage in their brains' large forward arteries. It's the most common kind of stroke so the results of the study can potentially affect thousands of people, a number that can reach up 125,000 in the United States alone every year.
Out of the subjects who underwent surgery to remove blood clots in their brains, 32.6 percent were able to achieve functional independence after just 90 days of suffering a stroke. Those who were given clot-dissolving drugs instead also experienced the same results but only in 19.1 percent of their group.
All patients in the MR CLEAN study who underwent surgery were administered clot-removing devices within six hours of experiencing stroke symptoms. Nine out of 10 patients were primarily treated with injections of clot-dissolving drug tPA before assigned to a surgery or drug group.
"Until now, people were lucky to get intravenous tPA. But the majority of those patients still have poor outcomes. The field was looking for a better option and MR CLEAN showed that we do have a better option," said Dr. Albert Yoo, Acute Stroke Intervention director from the Massachusetts General Hospital and co-author of the study, adding a difference in death rates was not registered but all other categories were better in the surgery group compared to the group taking clot-removing drugs.
The only major difference in side effects observed in the MR CLEAN study was that 5.6 percent of patients who underwent clot-removing surgery showed signs of subsequent strokes within a 90-day period after receiving the procedure. For the group taking clot-removing drugs only, just 0.4 percent of patients showed the same.
"This news has been awaited by the stroke community for quite some time and opens the door to the concept of more intervention for stroke patients with acute stroke. It is a very exciting point in the history of intervention for stroke, and will lead to further advances in our discipline," said Dr. Albert Favate, M.D., stroke neurologist for the NYU Langone Comprehensive Stroke Care Center. Favate was not part of MR CLEAN.
The study received funding support from the Dutch Heart Foundation.
Approved manufacturers of clot-removing devices include Penumbra Inc., Covidien and Stryker Neurovascular.
