This ought to be mandatory training and equipment in every ER and
trauma center
Stroke victims: Tiny coil saves lives by pulling blood clots from the brain
October 5, 2010 | Length: 00:03:13
A device known as the Merci Retriever is a potential life saver for stroke victims, but it must be used within 8 hours. The device looks like a tiny corkscrew and it is used for blood clots that occur in large arteries where clot busting drugs are not effective.
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RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain
Posted by Kirk Wilhelmsen
14th Oct 2010
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RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain
Posted by Kirk Wilhelmsen
14th Oct 2010
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RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain
Posted by doggydan@...
14th Oct 2010
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RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain
Wow, I agree with the previous poster, it should be in all ERs. This alone would save multi millions in health care costs.
Posted by marlene1065
14th Oct 2010
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RE: Stroke victims: Tiny coil saves lives by pulling blood clots from the brain
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.
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.
Posted by Kirk Wilhelmsen
14th Oct 2010
Transcript
Music
>>
Sumi Das: When Kurt Brunamen was rushed to the emergency room at the University of California in San Francisco, he was in very serious condition. Dr. Wade Smith is the neurologist who saw him.
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Dr. Smith: He was unable to speak, unable to understand commands. So if you were to ask him to lift up his right arm, or say his name, he was unable to do any of that. Kurt was looking at a life of disability, never working again.
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Sumi Das: Kurt had had a stroke caused by a blood clot in his brain. Dr. Smith is an expert in the Merci Retriever, a device that can remove previously untreatable clots, but it must be used within 6 hours of the onset of a stroke. Dr. Smith believed it could remove the clot that was threatening Kurt's life.
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Dr. Smith: A catheter, small tube, was placed in his groin, and the catheter was placed from the groin all the way up through the aorta, through the great vessels of the neck and into the brain. And then a small device was advanced through that catheter, just like a corkscrew, to engage the clot and the clot was pulled out of his brain.
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Sumi Das: Kurt's wife, Karen, saw him shortly after the procedure.
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Karen: He started to move his arm, and the nurse was in there as well and she was going to tie down because he was trying to take out the tube. And I said to her, well isn't that the side that he was paralyzed on? And she's like, you're right!
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Sumi Das: Thanks to the Merci Retriever, life is nearly back to normal for the Brunamen family.
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Karen: We as a family have a 2nd chance of having our lives and having a normal life, with no really disabilities at all. I mean it's really a miracle.
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Dr. Smith: To take a person who's on death's door and bring them back to life is an incredible privilege if it happens. But more importantly to bring someone back to life functionally, when we talk about brain science, that's our real goal.
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Sumi Das: Dr. Smith predicts that use of the Merci Retriever will continue to grow, because it's good for the patient and it's good for the bottom line.
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Dr. Smith: We're talking about 80 billion dollars of medical care spent per year on stroke alone, and if we can take those patients, we can take a quarter of them and return them back to work without any morbidity, the cost effectiveness of that if you think about dollars in medical care spent, is unquestionably cost effective.
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Sumi Das: Today Kurt Brunamen is back at work as a lieutenant with the San Francisco Police Department. It makes a big difference in his quality of life.
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Kurt: Being able to go back to work, it's a... it gives me back confidence that I can do whatever I want to do.
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Sumi Das: Each year an estimated 375,000 people in the U. S. have the type of stroke that Kurt had. This type of clot retrieving device may offer many of them 2nd chances at living fully functional lives as well. For Smart Planet, I'm Sumi Das.
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==== Transcribed by Automatic Sync Technologies ====