Stent Retrievers Recommended for Stroke Victims
Abstract： Stent retrievers are recommended by the American Heart Association. Clinical results demonstrated that the stent treatment removes blood clots in large arteries more completely compared to tPA, improves odds of survival
Recently, the American Heart Association/American Stroke Association published a focused update regarding treatment for acute ischemic stroke in the journal Stroke. In the update, the American Heart Association gives its high recommendation for the clot-removal devices called stent retrievers, which can remove blood clots that block large arteries supplying blood to the brain in stroke patients.
Since 1996, the FDA approved clot-busting drug tissue plasminogen activator (tPA) has become the primary treatment to dissolve the clot and recover blood perfusion in the brain. Intravenous tPA must be given within 4.5 hours of symptom onset to be effective. Several substantial studies published in the New England Journal of Medicine compared stroke patients only taking tPA to patients also treated with a stent retrieval device. The clinical results demonstrated that the stent treatment removes blood clots in large arteries more completely compared to tPA, improves odds of survival and benefits patients more than the potential risks.
The brain stent treatment procedure has to be done within 6 hours of acute stroke onset and the patients have to receive tPA beforehand. Doctors thread a thin catheter to the blocked vessel in the brain through an artery in the groin. At the blockage site, the stent in the catheter expands when doctors pull the catheter back and grasps the blood clot. Both the clot and the stent are pulled back out of the brain. It remains unknown if this stent treatment will also work without giving tPA as there is not enough supportive evidence.
In 2012, two stent retrieval devices were cleared by FDA, which are Solitaire, Minneapolis-based Medtronic, and Trevo, Stryker Corporation of Kalamazoo, Michigan. To respond to this new recommendation, there are physicians who are trained to do this and there are training programs set up, said Dr. William Powers, the head of the panel that made the recommendation.