Results of the 'MrCLEAN' clinical trial published by the NEJM

Today, December 17th 2014, the New England Journal of Medicine published the results of the MrCLEAN trial (Multicentre Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands). This prospective randomised trial was designed to show the potential of intra arterial (endovascular) treatment of ischemic stroke in comparison to conventional treatment with intravenous thrombolysis. The results of this trial are strongly positive towards intra arterial therapy, and will have a major impact on the future treatment of ischemic stroke.

The ESMINT (European Society of Minimally Invasive Neurological Therapies) strives towards a scientifically funded use of endovascular techniques in neurovascular pathology, by suitably trained and skilled medical specialists. In this respect the ESMINT applauds the researchers for their work and welcomes the outcome of the trial wholeheartedly.

Having said this, the ESMINT also warrants restraint since these complex endovascular procedures are highly operator dependent and should not be executed by persons without appropriate training and neurovascular knowledge. Execution of these procedures by anyone other than endovascularly trained neurovascular specialists poses a risk, both for the patients and the future of this technique. Awareness of these risks is of the utmost important to both legislators and hospital administrations that may consider employing doctors lacking the necessary training. Centralization of this particular service needs to be considered and may well be the only way to achieve the trial results in routine practice.

For more information please contact ESMINT directly.

The article can be read online here:
http://www.nejm.org/doi/full/10.1056/NEJMoa1411587#t=article