Southampton stroke patients took part in an international trial that will now guide treatment.
A surgical procedure to remove blood clots from large blood vessels is an effective treatment for a stroke, if done within a few hours.
It substantially reduces neurological disability and stroke severity and means a much higher proportion of patients will make a good recovery.
The results of a new trial will now guide its use in stroke patients with clots in medium-sized blood vessels. They have been published in the New England Journal of Medicine.
Dr Richard Marigold led the recruitment of eight patients from University Hospital Southampton (UHS). He is a Consultant Stroke Physician and part of the UHS Research Leaders Programme.
Clearing blood clots
Blood clots can block blood vessels and prevent blood flowing through them. This causes what is known as an acute ischemic stroke.
Mechanical thrombectomy (MT) is a surgical procedure used to treat patients after this type of stroke.
It involves inserting a long, thin tube, known as a catheter, into a blood vessel to remove the blood clot. This restores blood flow to the brain and prevents further damage.
Guiding stroke treatment
MT is known to be a very effective treatment, if carried out within 12 hours, for stroke patients with blood clots blocking large blood vessels.
The ESCAPE MeVO study aimed to see if it was also a good treatment option for patients with blood clots in medium-sized blood vessels.
Overall, 530 patients from five countries took part, following a stroke within the previous 12 hours. Most of them (84.7%) had a clot in a medium-sized blood vessel.
Around half of the patients were treated with MT, while the rest received standard care. The results showed that patients who had MT did not have better outcomes three months later.
The publication of these findings will now help to guide treatment decisions for these patients.
Dr Marigold said: “These results are extremely helpful. They will inform treatment decisions, helping us to give these stroke patients the best possible treatment.
“In most cases, treatment with a clot-busting medicine such as thrombolysis is as effective in clearing the clot with MT, but there will still be cases where MT is likely to be of benefit.
“We need to conduct further research to explore these results in more detail. This will investigate whether younger patients, or those with bigger clots in smaller vessels for example, might benefit from MT, and whether smaller and better devices to remove the clot in the future will make a difference.”