{"id":1051,"date":"2012-03-12T10:00:00","date_gmt":"2012-03-12T10:00:00","guid":{"rendered":"http:\/\/www.emlitofnote.com\/?p=1051"},"modified":"2016-08-01T08:58:42","modified_gmt":"2016-08-01T15:58:42","slug":"mechanical-thrombectomy-promising-but-still-unsafe","status":"publish","type":"post","link":"https:\/\/www.emlitofnote.com\/?p=1051","title":{"rendered":"Mechanical Thrombectomy &#8211; Promising, But Still Unsafe"},"content":{"rendered":"<p>This article is just a retrospective, consecutive case series from Spain reporting outcomes and adverse events from mechanical thrombectomy in acute stroke. &nbsp;Most of their patients are significantly disabled from their strokes, with NIHSS ranging from 12 to 20 &#8211; unlikely to have great outcomes &#8211; but 14% developed intraparenchymal hemorrhage and 25% were deceased at 90 days. &nbsp;Six patients had vessel wall perforation from the thrombectomy device.<\/p>\n<p>The key sentence is the last sentence:<br \/>&#8220;Clinical efficacy of this approach compared with standard medical therapy remains to be demonstrated in prospective, randomized controlled trials.&#8221;<\/p>\n<p>When mortality is 25% here, and 33% at 90 days in MERCI, multi-MERCI, and Penumbra trials, I&#8217;m still not sure this strategy is quite ready for prime time. &nbsp;They do report that 54% had a &#8220;good outcome&#8221;, but it&#8217;s interesting to see that &#8220;good outcome&#8221; in stroke trials has progressed from Rankin Scores of 0 or 1 in NINDS etc. to \u22642 in these new trials. &nbsp;They &nbsp;also don&#8217;t offer a lot of granularity in their outcomes data.<\/p>\n<p>But, as usual, as long as there are authors out there who &#8220;receive consulting and speaker fees from Co-Axia, ev3, Concentric Medical, and Micrus,&#8221; we&#8217;ll keep seeing reports like this.<\/p>\n<p>&#8220;Manual Aspiration Thrombectomy : Adjunctive Endovascular Recanalization Technique in Acute Stroke Interventions&#8221;<br \/><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22382156\" target=\"_blank\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22382156<\/a><\/p>\n\n<div class=\"twitter-share\"><a href=\"https:\/\/twitter.com\/intent\/tweet?via=emlitofnote\" class=\"twitter-share-button\">Tweet<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>This article is just a retrospective, consecutive case series from Spain reporting outcomes and adverse events from mechanical thrombectomy in acute stroke. &nbsp;Most of their patients are significantly disabled from their strokes, with NIHSS ranging from 12 to 20 &#8211; unlikely to have great outcomes &#8211; but 14% developed intraparenchymal hemorrhage and 25% were deceased &hellip; <a href=\"https:\/\/www.emlitofnote.com\/?p=1051\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Mechanical Thrombectomy &#8211; Promising, But Still Unsafe&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[14,15],"tags":[],"class_list":["post-1051","post","type-post","status-publish","format-standard","hentry","category-neurology","category-stroke"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7KesJ-gX","jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/1051","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1051"}],"version-history":[{"count":1,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/1051\/revisions"}],"predecessor-version":[{"id":2867,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/1051\/revisions\/2867"}],"wp:attachment":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1051"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1051"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1051"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}