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What’s the best treatment for people who are having strokes?

A new study adds to the evidence that a technique that uses a catheter to physically grab a blood clot leads to better results than drugs that break clots up.

A new study adds to the evidence that a technique that uses a catheter to physically grab a blood clot leads to better results than drugs that break clots up.

Many strokes occur when blood clots block blood vessels in the brain, starving tissue of oxygen. The tissue dies, causing disability or death.

The new study, published Tuesday in the Journal of the American Medical Association was a meta-analysis, a type of analysis that combines information from multiple studies.  This one by researchers at McMaster University used data from eight randomized clinical trials that involved 2,423 stroke patients.  Of those, 1,313 received what's called endovascular thrombectomy, or physical removal of the clots. That is often done with a device known as a stent retriever. The remaining patients received the current standard of care, which is treatment with the drug tissue plasminogen activator or tPA.

The chief drawback of the medication is that it must be administered within hours of stroke symptoms. Thrombectomy has a longer time window.

The new analysis found that 45 percent of the people whose clots were physically removed were functionally independent 90 days later.  That compared to 32 percent in the tPA group. Thrombectomy was also more likely to open blood vessels than tPA.

However, patients in the two groups were about equally likely to have a symptomatic bleeding problem in the brain or die.

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