(Stroke. 2004;35:2853.)
© 2004 American Heart Association, Inc.
Original Contributions |
Editorial Comment—A Mercy to Victims of Cerebrovascular Diseases
Assistant Professor of Neurology, First Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
The year 2004 has been a year of reinforcing the idea of treating ischemic stroke. Measures for recanalization per endovascular approach are again proved to be feasible in the brain vessels. In this issue of Stroke, Gobin et al report an unprecedented, promising phase I feasibility study of removing clots from occluded vessels by corkscrew Mechanical Embolus Removal in Cerebral Ischemia (Merci) Retrieval System.1 Treating ischemic stroke by embolectomy is not a new concept; however, until this year, the efficacy of the treatment is emerging and not too invasive.
Recently, the US Food and Drug Administration cleared the device for clot removing. Clot removing might be a reasonable way to treat the occluded brain vessels in practice, but the efficacy of treating acute ischemic stroke by this device is not yet unyielding; thus, the indication should be taken as pending approval. The requirements for approval of the efficacy might be as comparable to those applied to prourokinase from the Prolyse in Acute Cerebral Thromboembolism Trial (PROACT) II.2
Although IV recombinant tissue plasminogen activator has been available in many European and Asian countries since 2002, the short time window ruthlessly limited the treatment incidence. Prehospital delay has been more than enough.3 As shown in this study, limited to no patients had been treated in participating centers. Patients were additionally excluded if the arterial stenosis was proximal to the thrombus, in the opinion of the investigator. Either the number of patients screened or the number of the angiograms done before the
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