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    <title><![CDATA[Discussion on Stroke victims: Tiny coil saves lives by pulling blood clots from the brain ]]></title>
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        <title><![CDATA[RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain]]></title>
        <link><![CDATA[http://www.smartplanet.com/forum/discussions/1-4458-29091]]></link>
        <description><![CDATA[The way this is presented would make the public think that the Merci devise is a great advance. I think it is a marginal advance at best. I think the anecdotal experience that is the basis of the endorsement overly simplifies the collective experience in the literature with this device and a competing device. I am disappointed to hear ads boasting about its availability of the Merci device at hospitals. The direct marketing to consumers of drugs and devices is a bad idea. It has a ripple effect. ERs are mistakenly asking to transfer patients to places where this is available instead of using the better treatments  which they can use. The delay is clearly a big mistake.  The scientific paper that was used to gain approval of this and a competing device compared it with a medical option that could not get FDA approval. The Merci device and the competing device did only as well and often worse than an approach that was considered a medical failure. If the results reported for the Merci device were submitted under rules for a drug instead of a medical device I do not think it would not have been approved. The criteria for FDA approval are very different for drugs and devices. It is hard to interpret anecdotal experience in stroke. Some stroke patient get better without help, making it hard to attribute success with a device. It is hard to convince someone that sees that a patient got better after doing things that it was not due to their intervention. The dark side of this story is the number of times the catheter caused serious problem.  The sad fact is that patients that receive treatment after 4.5 hours have few good options. Treatment before 3 hours is much better than at 4.5.    If the option were offered to me or my family before 4.5 hours I would absolutely reject it. I would choose TPA. After 4.5 hours I would probably choose no treatment but might well succumb to the hope that the MERCI device might help. The videos are very seductive.]]></description>
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        <dc:creator><![CDATA[Kirk Wilhelmsen]]></dc:creator>
        <pubDate>Thu, 14 Oct 2010 13:16:45 -0700</pubDate>
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        <title><![CDATA[RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain]]></title>
        <link><![CDATA[http://www.smartplanet.com/forum/discussions/1-4458-29081]]></link>
        <description><![CDATA[Wow, I agree with the previous poster, it should be in all ERs. This alone would save multi millions in health care costs.]]></description>
        <guid><![CDATA[http://www.smartplanet.com/forum/discussions/1-4458-29081]]></guid>
        <dc:creator><![CDATA[marlene1065]]></dc:creator>
        <pubDate>Thu, 14 Oct 2010 12:04:43 -0700</pubDate>
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    <item>
        <title><![CDATA[RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain]]></title>
        <link><![CDATA[http://www.smartplanet.com/forum/discussions/1-4458-29042]]></link>
        <description><![CDATA[This ought to be mandatory training and equipment in every ER and trauma center]]></description>
        <guid><![CDATA[http://www.smartplanet.com/forum/discussions/1-4458-29042]]></guid>
        <dc:creator><![CDATA[doggydan@...]]></dc:creator>
        <pubDate>Thu, 14 Oct 2010 07:44:35 -0700</pubDate>
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