Fall 2004 Issue

Carolina Neurosurgery & Spine Associates Involved With New FDA-Approved Stroke Treatment

The Merci Retriever actually removes the blood clot from the blood vessel. (Click here to view an animation of the procedure.)
The Merci® Retriever, an innovative new treatment for stroke, recently received FDA approval. Carolina Neurosurgery & Spine Associates is proud to have been one of only two practices in the Carolinas and Virginia, and one of 10 sites on the entire East Coast, to participate in the clinical trial for the device. The Merci Retriever removes blood clots from the brain in patients experiencing ischemic stroke. It is estimated that ischemic strokes account for 80% of the 700,000 strokes that occur each year.

“This opens a new door of possibility and hope for people who suffer a stroke,” said Joe Bernard, M.D., a neurosurgeon with Carolina Neurosurgery & Spine Associates and primary investigator for the Merci Retriever at Carolinas Medical Center. “Previously, we only had the clot-busting drug TPA to treat a stroke. The Merci Retriever actually allows us to go up inside the blood vessel that is blocked, directly to the site of the problem, and pull the clot out. I’m proud that Carolina Neurosurgery & Spine Associates could play such a vital role in gaining FDA approval of this revolutionary device.”

The Newest Lifeline
The Retriever is a long, thin wire that is threaded through a catheter into the blood vessel. The wire is made of a special alloy. It is pushed through the end of the catheter and it reshapes itself into tiny loops that latch onto the clot and pull it out. To prevent the clot from breaking off, a balloon at the end of the catheter inflates to stop blood flow through the artery. (Click here to view an animation of the procedure.)

Until now, no tool was available that was strong enough to remove a clot without tearing blood vessel walls. There is still a risk of damaging the walls of blood vessels, which can cause bleeding in the brain.

Advantages Over TPA
Prior to approval of the Merci Retriever, the clot-busting drug TPA was the only treatment option for stroke. However, only one percent of patients actually use the drug, largely because it must be given within three hours of the onset of a stroke. Also, TPA cannot be used in patients who have recently undergone surgery, because it can cause heavy bleeding in the brain.

In contrast, the Retriever can be used within eight hours of stroke onset and can be utilized with patients who have recently undergone surgery. In addition, doctors can perform the procedure in as little as 20 minutes, in contrast, TPA can take
an hour or more to dissolve a clot.

Facts About Stroke
• According to the American Heart Association, stroke is the leading cause of serious, long-term disability in the US.

• Stroke is the third leading cause of death in the US, ranking behind heart disease and all forms of cancer.

• Stroke costs the US economy $53 billion annually.

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