AANS Neurosurgeon | Volume 27, Number 2, 2018


Earlier Treatment With Surgery to Remove Blood Clot Linked With Less Disability Following Stroke

In an analysis that included nearly 1,300 patients with large-vessel ischemic stroke, earlier treatment with endovascular thrombectomy (intra-arterial use of a micro-catheter or other device to remove a blood clot) plus medical therapy (use of a clot dissolving agent) compared with medical therapy alone was associated with less disability at 3 months, according to a study appearing in the September 27 issue of JAMA.

Five randomized trials have demonstrated the benefit of second-generation endovascular recanalization therapies over medical therapy alone among patients with acute ischemic stroke due to large vessel occlusions (blockage). However, uncertainties remain about the benefit and risk of endovascular intervention when under taken more than 6 hours after symptom onset. Michael D. Hill, M.D., M.Sc., of the University of Calgary, Calgary, Canada, and colleagues conducted a meta-analysis of the data from these 5 randomized trials (1,287 patients enrolled at 89 international sites). Demographic, clinical, and brain imaging data as well as functional and radiologic outcomes were pooled.


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