Rapid Endovascular Therapy Beneficial in Ischemic Stroke
(HealthDay News) — For patients with ischemic stroke, rapid endovascular therapy is associated with improved outcomes, according to two studies published online February 11 in the New England Journal of Medicine. The research was published to coincide with the American Stroke Association's International Stroke Conference, held from February 11–13 in Nashville, TN.
Bruce C.V. Campbell, MBBS, PhD, from the Royal Melbourne Hospital in Australia, and colleagues randomized patients with ischemic stroke who were receiving alteplase less than 4.5 hours after stroke onset to undergo endovascular thrombectomy with the Solitaire Flow Restoration stent retriever or to continue receiving alteplase alone. The trial was stopped early due to efficacy after 70 patients had undergone randomization. The researchers found that the there was a greater percentage of ischemic territory that had undergone reperfusion at 24 hours in the endovascular-therapy group than in the alteplase-only group.
Mayank Goyal, MD, from the University of Calgary in Canada, and colleagues randomized patients with acute ischemic stroke with a small infarct core, a proximal intracranial arterial occlusion, and moderate-to-good collateral circulation to receive standard care (118 patients) or standard care plus endovascular treatment with available thrombectomy devices (intervention; 120 patients). The trial was stopped early due to efficacy. The researchers found that the rate of functional independence was increased in the intervention versus the control group (53.0 vs. 29.3%; P<0.001).
"Among patients with acute ischemic stroke with a proximal vessel occlusion, a small infarct core, and moderate-to-good collateral circulation, rapid endovascular treatment improved functional outcomes and reduced mortality," Goyal and colleagues write.
The Goyal study was partially funded by Covidien, the manufacturer of the Solitaire stent used in both studies.