Three clinical trials been published  in the last three years(Mr CLEAN-Holland, ESCAPE-Canada, USA, Ireland .., EXTEND-IA-Australia and NZ) on the effectiveness of thrombectomy with stent-retriever in ischemic stroke, for thrombectomy / acute occlusions. Most of these studies focused on patients who were treated within 6 hours of onset of symptoms.

   Especially most of these trials patients  were previously treated with thrombolysis and after therapeutic failure to it,  endovascular treatment to recanalize was done in the thrombectomy active group. The recanalization rate get between 70-85% of cases with thrombectomy. Clinical improvement is achieved in 55-60% independence functional and imporment, also mortality decreases to 50%. This achive an NNT of 4 for functional independence and a NNT of 2 for mortality.

   The fourth trial, the SWIFT-PRIME in get more positive results and to the other trials with  thrombectomy  published previously. In addition, a study in four centers in Catalonia called REVASCAT the results were equally good in the same way.

However thrombectomy is a treatment offered to patients with large cerebral vessel occlusion and extensive clinical involvement. This occurs in 10% of patients with ischemic stroke.

   Intravenous thrombolysis is still the first choice of treatment in case of stroke less than 4.5hwith independence of the size of the occluded vessel and the vessel level, alwayswith agreements of other criteria  than temporary.

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News datas about efficacy of thrombectomy has been achieved in collaborative research group named HERMES.  A high relation between  PROCEDURE TIMES  and GOOD OUTCOME has been demonstrated in several articles. Click here: HERMES/TIME to check article.  Other article explain predictive value of time, click here in TIME TO PUNCTURE to check article of JAMA.