Trial demonstrates minimally invasive techniques (mechanically removing the clot that caused the stroke) for reopening a clogged blood vessel at the base of the brain are more successful than treatment methods routinely used today.
Each year in Europe 100-240 people in every 100,000 suffer a stroke. More than two thirds of the victims will have some disabilities for the rest of their lives and over half of them will die within 5 years. Traditionally the treatment involves medication to dissolve the clot.
Today, the New England Journal of Medicine published the results of the MR CLEAN trial (http://www.nejm.org/doi/full/10.1056/NEJMoa1411587#t=article)
They found that in a subgroup of patients, in whom the stroke was caused by occlusion of a large artery at the base of the brain, a treatment that involved mechanically removing the obstructing clot (thrombectomy) was more effective than the routine therapy of administering medication to dissolve the clot if they received treatment within the first six hours. The study was conducted in the Netherlands with 500 patients included.
“We are very pleased to see that the benefits of this treatment method have been demonstrated scientifically”, says Dr Istvan Szikora President of the European Society for Minimally Invasive Neurological Therapy (ESMINT), which represents and trains highly specialised physicians who perform thrombectomies throughout Europe.
“With these results it is hoped that the number of patients treated with this new method will increase so the best possible care can be provided to patients suffering from this disease” says Dr Szikora.
While welcoming the trial results, ESMINT emphasises that such treatment is only indicated for a selected group of patients and should be performed by specially trained physicians – neurointerventionists. In addition, these patients must be treated in dedicated centres with around-the-clock service and a fully-trained, multidisciplinary team.
“At present there are not enough trained physicians in Europe with the resources to handle the potential demand for this new treatment”, says Dr Szikora. “To address this challenge ESMINT has announced a new professional, accredited training course ‘ECMINT’ that will be run from Oxford in the UK.
The ECMINT course covers all the basic knowledge necessary for using minimally invasive techniques to treat vascular diseases of the brain including stroke.
ESMINT has been established in order to promote the benefits of minimally invasive neurological therapies in Europe through education, training and support for high quality scientific research.
ESMINT encourages and supports medical practitioners and scientists working to develop and improve minimally invasive methods for the treatment of neurological diseases. These methods will naturally evolve and currently involve the use of image guidance and medical devices such as endovascular catheters to perform treatments with minimum associated trauma.
The Society and Foundation promote the safe application of such techniques and their practice by suitably trained and competent practitioners throughout Europe. ESMINT encourages the setting of international standards for practice and research and encourages their use and appropriate implementation.
The Society (ESMINT) consists of individuals and groups of members working or training in geographical Europe in the field of minimally invasive neurological therapy. The members determine the organisational structure of the Society and are expected to aspire to the highest standards of ethical and scientific medical practice.