Mechanical embolectomy in acute ischaemic stroke--report of the first two cases

Intravenous thrombolysis is the only approved treatment for acute ischaemic stroke administered within 3 hours of onset. Mechanical embolectomy with the MERCI device is a new treatment option for patients with occlusion of a large cerebral artery who do not meet the current license criteria for thrombolysis, are admitted up to 15 hours from onset, or do not respond to treatment with recombinant tissue plasminogen activator (rt-PA). This is a report of the first two cases of acute ischaemic stroke treated with the MERCI device at our department. One did not meet the inclusion criteria for systemic thrombolysis, and the second did not improve despite rt-PA treatment. In both cases improvement of flow in the MCA was achieved and moderate neurological improvement was observed at 3-month follow-up. More studies and controlled trials are needed to establish the utility of mechanical embolectomy in the treatment of stroke.