ArticleNeurocritical care2007
The Merci Retrieval System for acute stroke: the Southeast Regional Stroke Center experience.
Article in Neurocritical care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 42 citations in OpenAlex.
- Neurothrombectomy in the treatment of acute ischaemic stroke.Nature reviews. Neurology · 2013Review
- A meta-analysis of observational intra-arterial stroke therapy studies using the Merci device, Penumbra system, and retrievable stents.AJNR. American journal of neuroradiology · 2013Article
- Achieving faster recanalization times by IA thrombolysis in acute ischemic stroke: where should we direct our efforts?Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2011Article
- Recanalization therapy for acute ischemic stroke, part 2: mechanical intra-arterial technologies.Neurosurgical review · 2011Review
- Current recommendations for endovascular interventions in the treatment of ischemic stroke.Current atherosclerosis reports · 2010Article
- In vivo evaluation of the Phenox CRC mechanical thrombectomy device in a swine model of acute vessel occlusion.AJNR. American journal of neuroradiology · 2010Article
- Penumbra Stroke System as an "add-on" for the treatment of large vessel occlusive disease following thrombolysis: first results.European radiology · 2009Article
- Endovascular approaches to acute stroke, part 2: a comprehensive review of studies and trials.AJNR. American journal of neuroradiology · 2009Review
- Intra-arterial stroke therapy: an assessment of demand and available work force.AJNR. American journal of neuroradiology · 2009Review
- Recent advances in intra-arterial thrombolysis.Annals of Indian Academy of Neurology · 2008Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe Merci Retrieval System was cleared for use in patients with stroke in August 2004. However, there are few published results of "real world experience" with the device.
methodsWe captured single-center data on 25 consecutive patients with acute ischemic stroke treated with the Merci Retrieval System according to the MERCI trial except that we treated some patients with tandem proximal carotid and intracranial lesions with carotid angioplasty and stenting and some patients were treated within the 3-hour window.
resultsMedian patient age was 63 years and median initial National Institute of Health Stroke Scale (NIHSS) score was 18. Isolated M1 or M2 middle cerebral artery lesions occurred in 52%, "carotid T" lesions in 8%, and vertebrobasilar lesions in 8%. Tandem lesions involving proximal carotid and proximal intracranial vessel occurred in 32%, necessitating emergent multilevel treatment including carotid stenting. Median duration from symptom onset to Merci device utilization was 5.2 hours. Successful reperfusion (> or = thrombolysis in myocardial infarction [TIMI] 2 flow) in the target vessel was obtained in 56% of cases. Statistical analysis revealed a strong correlation between ability to achieve greater than or equal to TIMI 2 flow and good clinical outcome as measured by 3-month NIHSS score, modified Rankin Scale (mRS), and mortality (nine out of the 12 without successful reperfusion died compared to none of the 13 with > or =TIMI 2 flow, p < 0.001). Younger age and lower NIHSS score on presentation were also predictors of good clinical outcome at 3 months.
conclusionThese "real world data" demonstrate that the results of the previous MERCI trial can be "independently replicated" at a regional stroke center. Although the results of placebo-controlled trials are still pending, mechanical revascularization has become a critical component of our acute stroke protocol, particularly for severe strokes. Issues still remain regarding recalcitrant lesions and operator experience, which necessitate further clinical testing and device optimization.
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