MERCI trial

Smith et al. Safety and efficacy of mechanical embolectomy in acute ischemic stroke. Stroke 2005; 36: 1432-1440.

Used device to open occluded intracranial large vessels within 8 hours. All patients were ineligible for iv tpa. Primary outcome measures were recanalization and safety. Secondary outcome measure was outcome at 90 days in recanalized v nonrecanalized patients. 46 % recanalized on an ITT. 7.1 % had significant complications. SICH occurred in 7.8 %. Good outcomes were more likely in patients who were recanalized.

Part I 55 patients Part !! 96 patients total 151. Criteria: NIHSS >8,. goal was TIMI 2. Mean NIH was 20. Mean time to treat was 4.3 hours. Vessel: ICA 19; ICA terminal bifurcation 14, MCA 57, VA 1 BA 9.

Six cases perf three embolized distal vessels, 3 more SAH 3 had significant groin hemorrhages. 7.8 % had SICH, 11 devices fractured ?due to over torquing device.

BY VESSEL: posterior 50 % favorable by NIHSS, 29-33 at MCA and ICA respectively. The 50 % recanalization of the MCA is less than that seen in PROACT 2 (66%).