New Devices Reignite Hope for Endovascular Stroke Therapy

Two randomized trials suggest (but do not prove) that mechanical thrombectomy improves functional outcomes.

The Interventional Management of Stroke III trial was recently stopped because low-dose intravenous tissue plasminogen activator (IV TPA) combined with thrombectomy or intra-arterial TPA did not improve outcomes compared with standard-dose IV TPA alone. This disappointing preliminary report is now followed by more encouraging publications from two other trials.

SWIFT and TREVO 2 are industry-sponsored randomized trials comparing new stent retrievers with the Merci Retriever, which was FDA-approved in 2004 as the first mechanical thrombectomy device. Both trials enrolled patients who could not receive or had failed to respond to IV TPA and could undergo thrombectomy within 8 hours of stroke onset. Participants had NIH Stroke Scale (NIHSS) sco…

Reviewing Author

Hooman Kamel, MD

Disclosures

Speaker’s bureauGenentech

Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund

Editorial boardsPLOS One; Scientific Reports

Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)