Mechanical Thrombectomy Improves Stroke Outcomes

The ESCAPE and EXTEND-IA trials confirm the recent results of the MR CLEAN trial and establish mechanical thrombectomy as a standard-of-care treatment for acute ischemic stroke.

Although thrombectomy devices became available years ago to treat acute ischemic stroke, whether this therapy actually improves outcomes was unclear. The first randomized, controlled trials found no benefit. These negative results were widely thought to arise from limitations of first-generation thrombectomy devices and unintended inclusion of patients without large-artery occlusion who thus lacked a viable thrombectomy target. Therefore, further trials were begun to assess newer devices only in patients with documented large-artery occlusion. The first of these trials — MR CLEAN — recently showed that thrombectomy produced a 14% absolute improvement in good 90-day outcomes (NEJM JW Neurol Feb 2015 and N Engl J Med 2015; 372:11). Now, inves…

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)

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)

Mechanical Thrombectomy Improves Stroke Outcomes

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Reviewing Author