Archive for the ‘STROKES’ Category


Sunday, March 4th, 2012


A new approach to stroke treatment initially developed by Dr. Jeffrey Saver’s group at the UCLA Stroke Center combines the ability to restore circulation and remove clots using only a single device … and it’s showing significant promise in trials. In a study comparing the Covidien Solitaire FR Revascularization Device with the FDA-approved Merci Retriever, the device successfully and safely treated roughly 60 percent of stroke patients, compared to roughly 30 percent when the Merci Retriever was used.

Such treatment is intended to minimize brain damage due to lack of oxygen and/or glucose in patients presenting with blockage of large intracranial blood vessels – particularly those for whom the use of clot-dissolving drugs is not advisable.

Roughly speaking, there are four main steps in the operation:

1. Poke a hole in the clot with a microcatheter (roughly 2.5 mm/0.1-inch in diameter).

2. Slide the Solitaire device through the microcatheter until it extends on either side of the clot.

3. Slide the microcatheter back so that the Solitaire device expands and traps the clot.

4. Pull the Solitaire device back to the end of the microcatheter, and use suction to remove the clot from the blood vessel.

Various stages in the revascularization and clot removal procedure are shown in the picture gallery.

The Solitaire With the Intention For Thrombectomy (SWIFT) study was designed to compare the results of using the Solitaire on acute stroke patients with the FDA-approved Merci Retriever. The Merci Retriever functions like a corkscrew that snares and removes a clot, but has a tendency to uncoil and lose the clot.

The SWIFT study was ended prematurely because of the remarkable effectiveness of the Solitaire device. One hundred and forty-four patients with acute ischemic stroke who either were not candidates for clot-busting drugs or in whom they had been ineffective were chosen for the study. Patients were a mixed lot, but both treatment groups were very similar. The patients were randomly assigned to be treated with the Solitaire or with the Merci devices.

The results:

    • Reestablishment of blood flow occurred in 83% of the Solitaire treatments versus 48.1% of the Merci treatments
    • Reestablishment of blood flow without symptoms due to intracranial hemorrhage occurred in 60.7% of the Solitaire treatments versus 24.1% of the Merci group

The Solitaire group had lower mortality at 3 months: 17.2% versus 38.2% for the Merci treated patients

  • Good mental/motor functioning was restored within 90 days in 58.2% of Solitaire patients as compared to 33.3% of Merci patients

“Initial treatment with Solitaire rather than Merci is associated with more frequent reperfusion, less symptomatic intracranial hemorrhage, reduced mortality, and increased good neurologic outcomes,” says Dr. Saver. More simply put, the Solitaire device does its job more effectively and causes fewer problems while doing it.

The Solitaire is now approved for use in the Interventional Management of Stroke trial study. This is a stage III clinical trial, started in 2006, whose purpose is to examine if a combination of clot-busting drugs and intra-arterial therapy is more effective than clot-busting drugs alone. Among the intra-arterial therapies is the Merci Retriever. Even though over 675 of the 900 patients participating in the trial have already been studied, it has been expanded to include the Solitaire as an intra-arterial treatment for the remainder of the study.

Inclusion in the IMS clinical trial study reflects the enthusiastic response of the neurological medical community for the results of the SWIFT study. Hopefully the FDA will put Solitaire on the fast track as well.

Sources: UCLA, Covidien

Published by Henry Sapiecha


Monday, April 4th, 2011

Head-worn device uses sonar to rapidly diagnose stroke
A team of radiologists and retired US Navy sonar experts have used technology developed for submarines as the basis for a new device which offers quick detection, diagnosis and monitoring of stroke. Combined with a portable laptop based console, the head-worn device enables different types of stroke and brain injury to be discovered and located, differentiating normal blood flow from life threatening conditions and delivering an initial diagnosis in under a couple of minutes. Read More

Received & published by Henry Sapiecha


Thursday, February 3rd, 2011

Popular painkillers linked to heart and stroke risk

Feelin’ lucky? Then go ahead – pop that painkiller.

But you’d better hope that today’s not the day your luck finally runs out, because some of the most commonly used pain meds carry a major death risk.

The drugs are those nonsteroidal anti-inflammatories used by millions for everything from arthritis to headaches to back pain. And now, researchers say they can double, triple, and even quadruple your odds of heart attack, stroke, and an early death.

Swiss researchers looked at data from 31 “gold-standard” trials that included 116,429 patients, and found that ibuprofen – a med probably in your own home right now – can triple the risk of stroke.

And diclofenac, a widely used generic prescription NSAID, can quadruple the risk of death from heart attack and stroke.

These problems aren’t rare by any stretch. In fact, the researchers say that for every 25 to 50 patients who take NSAIDs for a year, there will be one extra heart attack or stroke.

That’s overall.

But they also believe that patients who already have heart problems could face a much higher risk when they pop those pills – like the millions of seniors who battle both heart disease and arthritis.

The researchers found naproxen (aka Aleve) to be the “safest” of the NSAIDs, but don’t kid yourself – “safest” doesn’t mean “safe.” All painkillers carry risk – and regular use of any NSAID can lead to bleeding problems, ulcers, and more.

And that means you need to be careful with how – and how often – you use these things, no matter how old you are or what risks you face.

If you need one from time to time, you need one – and I won’t stand in your way.

But if you’re taking one of these things regularly, there’s clearly something else going on – and you and your doc need to get to the bottom of it.

If you go looking for that answer at the bottom of a painkiller jar, you could find yourself at the bottom of a grave.

Sourced & published by Henry Sapiecha