Stroke: Mr Clean Study of Endovascular Treatment Interview with:
J.H.L. Mulder, MD PhD
Neurology resident
Erasmus MC What is the background for this study? What are the main findings?

Response: Current information about safety and efficacy of endovascular treatment (EVT) for acute ischemic stroke is primarily derived from patients treated in the setting of a randomized controlled trial. However, inherent to this setting, external validity of the results can be jeopardized by patient selection and intensive monitoring.

Therefore, an important question remained unanswered: could the positive effect of endovascular treatment be reproduced in standard clinical practice? What should readers take away from your report?

Response: The results of MR CLEAN Registry, a nationwide study in the Netherlands, answers this question and shows that in a setting in which endovascular treatment is standard of care, this treatment is at least as effective and safe as was shown in the clinical trials, even if applying more general selection criteria.

The greater benefit may have been caused by shorter stroke onset to treatment times. What recommendations do you have for future research as a result of this work?

Response: Our findings should encourage use of endovascular treatment for patients with acute stroke due to a large vessel occlusion in the anterior circulation as standard of care, in the Netherlands as well as in other countries, provided that the infrastructure enables treatment within 6 hours after symptom onset and treating doctors completed adequate training. 

No disclosures 


Time to Endovascular Treatment and Outcome in Acute Ischemic Stroke: MR CLEAN Registry Results

Maxim J.H.L. Mulder, Ivo G.H. Jansen, Robert-Jan B. Goldhoorn, Esmee Venema, Vicky Chalos, Kars C. J. Compagne, Bob Roozenbeek, Hester F. Lingsma, Wouter J. Schonewille, Ido R. van den Wijngaard, Jelis Boiten, Jan Albert Vos, Yvo B.W.E.M. Roos, Robert J. Oostenbrugge, Wim H. van Zwam, Charles B.L.M. Majoie, Aad van der Lugt, Diederik W.J. Dippel
and for the MR CLEAN Registry investigators
Circulation. 2018;CIRCULATIONAHA.117.032600

Originally published March 26, 2018

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Last Updated on March 29, 2018 by Marie Benz MD FAAD