Does Intra-Arterial Treatment Benefit Patients With Ischemic Stroke?

“Our study benefited from the widespread availability of retrievable stents, which were used in 82% of the patients in the intervention group. These devices were recently shown to be superior to the first-generation Merci device for both revascularization and clinical outcomes.” Yet the study was limited by slightly unbalanced randomization, a relatively low reperfusion rate, and patients’ awareness of their treatment group assignments, Dr. Berkhemer said.

One Small Step?
“MR CLEAN is the first step in the right direction,” said Werner Hacke, MD, PhD, Professor and Chairman of the Department of Neurology at the University of Heidelberg in Germany, in an accompanying editorial. Other investigators are conducting similar trials, and “it is premature to conclude that there is no longer equipoise regarding thrombectomy,” he added. “We need and will get results from other well-designed trials, not only to confirm or refute the results of MR CLEAN, but also to look at effects in subgroups (according to stroke severity, occlusion site, or time to treatment initiation), for which most single trials are underpowered.”

—Erik Greb