What is Merci Retrieval System?
The Merci Retrieval System is an endovascular device for removal of acute intracranial thrombus. We present our initial experience using this device in conjunction with existing thrombolytic therapy already in place in our institute.
How is clot retrieval done?
A smaller catheter (‘microcatheter’) is used to cross the clot, and then a ‘stent retriever’ – a small wire mesh cage – is passed through the microcatheter to capture the clot. The stent retriever is then removed while suction is applied through a larger catheter on the blood clot.
What is the window for thrombectomy?
The new guideline, based on the most recent science available, recommends that large vessel strokes can safely be treated with mechanical thrombectomy up to 16 hours after a stroke in selected patients. The expanded treatment window from six to 16 hours is based on clinical evidence from the DAWN and DEFUSE 3 trials.
What is Merci in medical terms?
The MERCI Retriever is a medical device designed to treat Ischemic Strokes. The name is an acronym for Mechanical Embolus Removal in Cerebral Ischemia.
What is the best treatment for brain stroke?
An IV injection of recombinant tissue plasminogen activator (tPA) — also called alteplase (Activase) — is the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm with the first three hours. Sometimes, tPA can be given up to 4.5 hours after stroke symptoms started.
Can all strokes be treated with clot busting medication?
Alteplase (brand name Activase) – a tissue plasminogen activator (tPA) – works by breaking up blood clots, allowing blood to flow to the brain. It is the only medication approved by the FDA for treatment of ischemic stroke.
How does Merci work?
The Merci Retriever is a mechanical embolectomy device designed to reopen occluded vessels by extracting occlusive thrombi from the cerebral vasculature.
How does the Merci clot Retriever Work in practice?
In practice, the catheter/wire is passed distal to the thrombus, the catheter is removed, and the helical configuration assumed by the wire; the clot is then trapped in the helix and withdrawn from the vasculature ( Figure 2 ). The 510 (k) clearance means that the Merci Retriever was felt to be substantially equivalent to a predicate device.
Is there a clinical trial for Merci mechanical thrombectomy Retriever?
Although the Merci retriever showed a good recanalization rate, there are currently no randomized clinical trials to assess its clinical efficacy in comparison with systemic thrombolysis within a window of 3 to 4.5 hours or with standard of care beyond a 4.5-hour window. acute ischemic stroke; confidence interval;
Which is better merci or penumbra thrombectomy?
Symptomatic intracerebral hemorrhage was identified in 7.3% of patients treated with Merci retriever, a result comparable to that in the PROACT II and Penumbra thrombectomy trials. Successful recanalization, lower NIH Stroke Scale score, and younger age were identified as the strongest predictors of favorable outcomes.
What was the mortality rate in Merci pivotal trials?
MERCI pivotal trials. In a pooled analysis of the MERCI and multi-MERCI trials, the rate of revascularization was 73% in the IV-tPA group vs 63% in the remaining sample, with a mortality rate of 27.7% and 40.1%, respectively. However, favorable outcome was not significantly different (38% vs 31%).