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New device removes clots from brain

29 August, 2012

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WASHINGTON: A new device that removes clots from the brain could be a game changer in the treatment of strokes, say researchers.

In a recent clinical trial, the SOLITAIRE Flow Restoration Device, approved by the US Food and Drug Administration this March, outperformed the standard treatment. SOLITAIRE is among an entirely new generation of devices designed to remove blood clots from blocked brain arteries.

It has a self-expanding, stent-like design, and once inserted into a blocked artery using a thin catheter tube, it compresses and traps the clot. The clot is then removed by withdrawing the device, reopening the blocked blood vessel, the British journal The Lancet reports.

"This new device is significantly changing the way we can treat ischemic stroke (caused by blockage of an artery to the brain)," said Jeffrey L. Saver, director of the University of California Los Angeles Stroke Centre and a professor of neurology at the David Geffen School of Medicine.

"We are going from our first generation of clot-removing procedures, which were only moderately good in reopening target arteries, to now having a highly effective tool," added Saver, who led the study, according to a California statement.

Results of the study showed that the device opened blocked vessels without causing symptomatic bleeding in or around the brain in 61 percent of patients.

The standard FDA-approved mechanical device, a corkscrew-type clot remover called the MERCI Retriever, was effective in 24 percent of cases. The use of SOLITAIRE also led to better survival three months after a stroke.

There was a 17.2 percent mortality rate with the new device, compared with a 38.2 percent rate with the older one.

About 87 percent of all strokes are caused by blood clots blocking a blood vessel supplying the brain.

The stroke treatment that has received the most study is an FDA-approved clot-busting drug known as tissue plasminogen activator, but this drug must be given within four-and-a-half hours of the onset of stroke symptoms, and even more quickly in older patients.

When clot-busting drugs cannot be used or are ineffective, the clot can sometimes be mechanically removed during, or beyond, the four-and-a-half-hour window.

The current study, however, did not compare mechanical clot removal to drug treatment.

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