Mechanical blood clot removal led to good recovery in half of stroke patients
Research Highlights:
- In a "real-world" international study comprising 1,000 patients, nearly half of stroke survivors achieved good to ideal outcomes at three months after the stroke if they had received mechanical clot removal.
- For most patients in this study, only one attempt of mechanical clot removal was required.
- The study also identified which types of blood clots - those rich in red blood cells and low in platelets - were linked to a greater likelihood of survival with less disability.
NewMediaWire) -
The most common type of stroke, an ischemic stroke, is caused by a blood clot in a blood vessel that blocks the flow of blood to the brain. Treatment usually involves clot-busting medications to dissolve the clot. For severe stroke within a large blood vessel, the treatment also may include a procedure to remove the clot - called mechanical thrombectomy or endovascular therapy - in which a tiny tube, or catheter, equipped with a special device on the end, is threaded through the blood vessel to grasp the clot and remove it.
Previous studies found that stroke patients who received mechanical clot removal had less disability after three months than those who did not. However, these studies were performed in carefully selected centers and employed strict clinical and imaging inclusion criteria, which decreases the generalizability of their findings.
To examine the effectiveness of blood-clot removal across a wide range of stroke patients seen in routine daily care (outside of a clinical trial), the Embotrap eXtraction & Clot EvaLuation & Lesion Evaluation for NeuroThrombectomy, or EXCELLENT trial, enrolled 1,000 adult ischemic stroke patients (average age 70, 52% female) at 36 sites worldwide, from
Notably, the study was designed to collect real-world treatment and did not exclude patients based on pre-stroke independence level, severity of stroke, location of the occlusion, or time between onset of stroke and treatment, researchers said (as per current guidelines mechanical thrombectomy treatment can be used within 24 hours of symptom onset in select patients). In addition, the study analyzed the characteristics of the removed blood clots and how that impacted stroke recovery.
The study found that most of the patients required only one attempt to remove the blood clot. However, it is common to require multiple attempts to completely remove the clot. In nearly half of all patients, clot removal resulted in slight/minimal disability (able to look after own affairs without assistance or no worsening from their pre-stroke condition), as gauged by a standard scale measuring level of disability 90 days after stroke.
"This study shows how much stroke thrombectomy has advanced," said lead study author
The study also found blood clots that were rich in red blood cells and low in platelets resulted in less disability than blood clots composed of less red blood cells or those rich in red blood cells and high in platelet content.
Red blood cells contain the protein hemoglobin, which carries oxygen throughout the body. Fibrin is a protein, and platelets are cell fragments that help blood to clot, to help stop bleeding, however, in a stroke, clots block blood flow to the brain. Different proportions of these elements alter the blood clot consistency and its physical properties. This may facilitate or impair the clot removal procedure.
In this study, only 10% of patients whose clots had a higher composition of red blood cell count and a lower composition of platelets died within 90 days, compared to 24% of patients whose clots had a lower composition of red blood cells and platelets. Among patients with higher red blood cell content, 63% with lower platelet content had either slight or no disability, compared to 51% with higher platelet content.
"We knew that fibrin was associated with more difficult clot removal. However, this novel observation that platelets may modify clot properties is very intriguing," Nogueira said. "The results may have potential implications for technique and device selection when removing clots and the development of better blood-clot removal strategies."
Worldwide, stroke is the second-leading cause of death and a leading cause of long-term disability. Stroke is a medical emergency requiring immediate treatment, so it is important to recognize early signs and how to respond to them: Face drooping, Arm weakness, Speech difficulty, Time to call 9-1-1, remembered with the acronym F.A.S.T.
Co-authors are
The study authors reported funding by Cerenovus, part of
Statements and conclusions of studies that are presented at the
The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association's overall financial information are available here.
Additional Resources:
- Multimedia is available on the right column of release link https://newsroom.heart.org/news/mechanical-blood-clot-removal-led-to-good-recovery-in-half-of-stroke-patients?preview=be31caf72dc568a84b79803a51fe66cd
- AHA news release: Prompt clot-grabbing treatment produces better stroke outcomes (
Jan. 2018 ) - AHA news release: Guidelines urge new approach to treating worst strokes (
June 2015 ) - For more news at
ASA International Stroke Conference 2022, follow us on Twitter @HeartNews #ISC22.
About the
###
For Media Inquiries and AHA Expert Perspective:
For Public Inquiries: 1-800-AHA-USA1 (242-8721)
heart.org and stroke.org
ESG – Social Considerations for Insurers in the US 2021: Policy Makers Concerned with Bias in AI and Automated Underwriting – ResearchAndMarkets.com
AM Best Assigns Issuer Credit Rating to Definity Financial Corporation
Advisor News
- Most Gen Z investors think less than a year ahead when making financial decisions
- IRI pitches retirement agenda to Jeffries as democrats shape affordability platform
- Help child-free clients plan for their later years
- When new investment trends emerge, Gen Z is most likely generation to be first in
- Could ‘plain English’ become an advisor’s secret weapon?
More Advisor NewsAnnuity News
- Guidance, bulletin or reg? NAIC debates form of annuity illustration update
- Nationwide adds mutual fund-linked strategy to New Heights Select FIA
- NUNN INTRODUCES BILL TO CUT RED TAPE, GIVE IOWANS CLEARER INSURANCE INFORMATION
- NAIC working group pressed to accelerate annuity illustration overhaul
- State Auditor James Brown Kicks Off Life Insurance Awareness Month With Policy Locator Tool
More Annuity NewsHealth/Employee Benefits News
Life Insurance News