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CSMC is First with Clot-Retrieval Device

Cedars-Sinai is First Medical Center in California

to Offer New Clot-Retrieval Device for Stroke

Cedars-Sinai is the first medical center in California to use a new clot-retrieval device for patients with acute stroke. The catheter-delivered Penumbra System received FDA approval in late December 2007 and has been available at Cedars-Sinai since mid-January.

"Initial data from use of the Penumbra device indicates it may be effective in retrieving clot from blocked arteries in the brain in approximately 80 percent of patients within eight hours of the onset of their symptoms, giving patients a better chance at recovering from a stroke," said Michael J. Alexander, M.D., Director of the Neurovascular Center and Director of Endovascular Neurosurgery. Dr. Alexander sat on the data safety and monitoring board for Penumbra device safety study.

The only other mechanical thrombolysis device available on the market, designed to hook and withdraw a clot, has been effective in approximately 50 percent of cases. Penumbra offers a new therapeutic modality by providing the ability to aspirate soft clot out of the blocked arteries in the brain in the setting of acute stroke.

The Penumbra System may be used alone or in conjunction with IV tissue plasminogen activator (tPA).

"A patient may be given a dose of IV tPA at another hospital before transfer to our stroke center for definitive care. That does not preclude the use of the Penumbra device," Dr. Alexander said. "On the other hand, if a patient comes here directly and we find in the angiography suite that there is a large clot and the patient is outside the 3 hour window for IV tPA, we would just go immediately with the clot-retrieval device."

Because tPA must be administered within the first three hours of symptom onset, and few patients receive care in that time frame, the use of mechanical thrombolysis devices can increase the window of opportunity for effective treatment. Clot retrieval may be the only option for patients who are not candidates for the use of blood thinners. Also, tPA may take several hours to dissolve a clot, increasing the risk of a poor outcome, but a mechanical device can have immediate results.

"Patients with acute stroke have a very poor prognosis, and this treatment will not be successful for everyone," Dr. Alexander said. "But this is the cutting edge of therapy that will allow us to retrieve clots in a greater percentage of patients."