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Politics : Stockman Scott's Political Debate Porch -- Ignore unavailable to you. Want to Upgrade?

To: lurqer who wrote (37106)	2/6/2004 12:59:32 AM
From: stockman_scott	Respond to of 89467

Breaking News: Cheney's Office Named in Criminal Leak of CIA Agent's Name veteransforcommonsense.org

To: lurqer who wrote (37106)	2/6/2004 1:21:37 AM
From: lurqer	Respond to of 89467

A now for a total change of pace, a good news post. Dramatic Results Against Stroke An experimental device that works like a miniature corkscrew can halt often-devastating strokes by gently pulling blood clots from the brains of victims in the throes of an attack, researchers reported yesterday. In the largest test of the new technique, doctors extracted blockages in dozens of patients around the country who otherwise would have probably died or suffered serious brain damage. In some cases, the procedure immediately restored their ability to move and talk, the researchers said. Although the approach requires much more testing and perhaps refinement, a Food and Drug Administration panel will evaluate the device at the end of the month and could recommend that it be cleared to give doctors a powerful new tool to fight one of the nation's biggest killers. About 700,000 Americans suffer strokes each year and nearly 170,000 die, making strokes the third leading cause of death after heart attacks and cancer. Most strokes occur when a blood clot lodges in a vessel in the brain, cutting off blood flow and killing brain tissue. Those who survive are often left paralyzed and dependent on others for care, making strokes the leading cause of disability. Currently, the only way doctors can stop a stroke once it has started is to give patients a clot-busting drug called tissue plasminogen activator (tPA). But tPA is approved for use only within the first three hours of a stroke; cannot be used on many patients; and takes one to two hours to work, often leaving victims brain-damaged. So researchers have been trying to develop alternative methods, such as destroying clots with ultrasound, lasers or capturing and removing them with tiny baskets. The new device, known as the Concentric MERCI Retrieval System, has undergone the most extensive testing of the new approaches. The system involves inserting an extremely small tube containing the device into an artery in the groin and then snaking the device through the body until it reaches the clot in the brain. A nickel-and-titanium wire springs into a coiled corkscrew shape when deployed from the end of the tube, embedding itself into the clot. After snagging the clot, it is pulled back into the tube and a balloon inflates, temporarily blocking blood from flushing the clot back into the brain. The device is then withdrawn, removing the clot and restoring blood flow. "It's just like pulling the cork out of a wine bottle," said Sidney Starkman, a professor of emergency medicine and neurology at the University of California at Los Angeles, who led the study. Doctors tried the technique on 114 patients who could not undergo tPA treatment at 25 centers around the country. The device successfully removed clots in 61 of them as long as eight hours after the stroke began, Starkman reported at the American Stroke Association's 29th International Stroke Conference in San Diego. "This study was primarily a safety study to see whether or not we could even do it. It was pretty amazing that, yes, we could pull clots out of blood vessels in people's brains," he said in a telephone interview. In some case, the results were dramatic, with patients who were paralyzed suddenly regaining the ability to talk and move. "Have you heard about the Lazarus effect -- where Lazarus comes back from the dead? In a way, it's like the Lazarus effect," Starkman said. "Here you are doing this procedure on a patient who can't talk and can't move, and here you can make them normal. That's really what it's like. It sends chills up and down my spine." Of those patients who had clots removed, 53 percent had very good recoveries, with most being left with no problems or only relatively minor disabilities, Starkman said. "Patients were able to look after their own affairs without assistance. Most of those were able to carry out all their usual duties and activities after their stroke," Starkman said. Other researchers cautioned that it remains difficult to evaluate the technique, in part because it has not yet been tested in a study that compared patients who underwent the procedure to those who had not, and because patients in the study had not been followed for long enough periods of time afterward. "We're excited that there may be another potential tool," said Joseph Broderick, chairman of neurology at the University of Cincinnati. "At the same time, there's a lot more work to be done. This is not something that's ready for prime-time use without further evaluation." The National Institutes of Health is sponsoring a follow-up study in which patients who received the treatment will be compared to those who receive only blood thinners. But an FDA panel on Feb. 23 will consider an application by Concentric Medical Inc. of Mountain View, Calif., to approve the device based on the results released yesterday. washingtonpost.com lurqer