Items Tagged ‘florida news release’
Posted on October 17th, 2013 by Cynthia (Cindy) Weiss
MULTIMEDIA ALERT: For audio and video of Vandana Bhide, M.D., talking about the flu and flu vaccinations, visit the Mayo Clinic News Network.
Jacksonville, FL — Flu season is upon us, and despite what most people think, influenza is a serious and potentially deadly disorder. The Centers for Disease Control and Prevention estimates that an average of 30,000 deaths occur annually as a result of flu and associated complications. With last year's flu outbreak ranking among the worst in recent history, Mayo Clinic experts offer advice and dispel many misconceptions about the flu to help people stay healthy.
"The vaccine is the best defense against flu and serious flu-related conditions, and because it's difficult to predict how and when the flu will strike, I recommend getting it as early as you can," says Teresa Seville, M.D., Infectious Diseases, Mayo Clinic in Arizona.
Vandana Bhide, M.D., internal medicine specialist at Mayo Clinic in Florida, advises everyone to consider a flu shot, particularly those at high risk for complications — individuals over the age of 65, pregnant women, children 6 months to two years, and individuals with chronic medical disorders or who are immune-compromised. "Though many people who get the flu will have fever, muscle aches and need to stay home from work or school for a few days, certain people can develop serious complications, which could include pneumonia, bronchitis, sinus infections and other conditions. The vaccine can help avoid these issues."
This year, there are several new options for vaccination, including a shot and nasal spray with four strains of influenza rather than the traditional three strains. A high-dose vaccine for the elderly is also available as well as a new vaccine without egg proteins, for those with egg allergies. "There is an option for everyone," says Dr. Bhide.
One of the most common myths about the flu is that the vaccine will cause the flu. "Although many people believe this, it is a myth," says Jennifer White, M.D., family medicine physician at Mayo Clinic Health System in Springfield, Minn. "Injectable flu vaccines are composed of portions of inactivated flu proteins, and it's impossible for them to cause the flu. Nasal spray vaccines have live, weakened flu organisms that can't multiply or cause disease."
Dr. White adds that pregnant women are encouraged to use the injectable vaccines as the nasal sprays have not yet been studied in pregnant women.
"In general, the best way to avoid getting sick with the flu is by getting vaccinated and practicing healthy habits," says Dr. Seville.
Here are some tips for avoiding illness:
For more information about preventing the flu, please visitmayoclinic.com.
Journalists can become a member of the Mayo Clinic News Network for the latest health, science and research news and access to video, audio, text and graphic elements that can be downloaded or embedded.
Posted on September 19th, 2013 by Admin
JACKSONVILLE, Fla. — Lillian Shirley traveled from central Florida to Jacksonville for treatment of a kidney problem because of Mayo Clinic's efficiency. While waiting for an endoscopic procedure on the fourth floor of Mayo Clinic Hospital, Shirley received an additional benefit from an unexpected, four-legged visitor.
"I looked at him straight in the eye and told him what pretty brown eyes he has," Shirley says. Her earnest, "face-to-face" visitor answers to the name of Sunday, and he's part of the Caring Canines program at Mayo Clinic. The volunteer program features specially trained dogs and their owners who "meet and greet" patients and visitors at the clinic.
Clinical efficiency brought Shirley to Mayo, but Sunday provided an additional empathic experience that won't show up on her hospital bill.
In a waiting area full of people, Sunday came right up to her, allowed her to hold his face in her hands and held her gaze, accepting her compliment with grace, silently letting her know everything will be alright.
In the same waiting area, Wanda Aills sat with her sister-in-law and other family members awaiting news of her brother's surgery. Aills' face lit up when Sunday arrived, and he responded by walking in her direction and gently placing his paw on her lap.
"I felt a sense of calm," Aills says. "Interacting with a therapy dog takes you out of the situation you're in, even for a few minutes. I've heard of using therapy dogs in a hospice setting, and I was surprised they incorporate them in a hospital. But it makes sense — they say relieving stress is the beginning of healing."
The principle of integrated medicine and of healing body and soul is embedded into the philosophy of Mayo Clinic. Programs that support art, music and pet therapy are embraced at all three Mayo Clinic sites in Arizona, Florida and Minnesota. At Mayo Clinic Florida, the Caring Canines began visiting Radiation Oncology in 2011. As the benefits became evident (supported by patient and staff surveys), more volunteers and their dogs joined the program.
Currently 18 dogs and their owners volunteer in patient waiting areas in Radiation Oncology, Surgery and Diagnostic Radiology. Seventeen other teams are on a waiting list for the required classes.
"People expect efficient and compassionate care at Mayo Clinic, and the Caring Canines bring an extra benefit to their experience," says Nancy Skaran, international administrator and one of the program's founders. "They provide a welcome distraction from medical procedures in so many ways — entertainment, nurturing, mental stimulation and decreasing anxiety."
Kristi Leonard is the owner of Sunday, a soft and calm 3-year-old goldendoodle (with the pretty brown eyes). She says one patient scheduled her radiation treatments around Sunday's volunteer day, just so she could spend time with him.
"We've been volunteering every Thursday for the past two years," says Leonard. "One of the requirements is that the dog must be bathed within 24 hours before coming in. We must offer everyone who touches the dog hand sanitizer — not so much because of the dog but because of how many people interact with the dog during a visit."
The Caring Canines wear their own Mayo identification badge, and they must pass several tests before being admitted to the program.
"We went through eight weeks of training where not only does the dog get trained, but the owner must learn how to read his signals," Leonard says. The dogs and owners are trained to handle different stressful situations such as loud noise or monitor beeping to ensure the dog is calm enough to be in a clinical environment. Visits to clinical areas can't exceed 90 minutes to allow the dogs to diffuse some of the energy they absorb from humans.
Leonard is a stay-at-home mom of three who had previous experience with therapy dogs. She says volunteering at Mayo Clinic gives her the chance to have a flexible schedule and be involved in the community.
"Sometimes I feel like I get more out of it than the patients do, and there are some tender moments," Leonard says. "I just know that Sunday was put on this earth to do this. I'm just the one at the other end of the leash."
Lindy is a trim, 5-year-old golden retriever who gets three to four miles of exercise daily. She loves those jaunts, but it's coming to Mayo Clinic that really gets her excited.
Lindy and her owner, Joan Streightiff, joined Caring Canines in November 2012. After retiring from a high-stress career with management responsibilities, Streightiff was more than ready for Caring Canines. "I wanted something more low key – and something with Lindy," she says. "She knows Mayo Clinic and gets excited when we turn into the parking lot. It starts from the time we get out of the car — people smile and wave. Patients have even started recognizing her when we walk through the halls." A recent highlight was a hallway encounter with seven children, four of them with a potential transplant patient. Lindy patiently let each one pet her. "Is she a helper dog?" one of them asked.
Lindy has her routine when visiting Diagnostic Radiology — always greeting staff members first. She loves to be petted and turns her back to patients so they can reach her easily. "If she sits on your foot, that means she likes you," Streightiff says.
Each dog and owner is tested and registered through a national organization. They also go through Mayo Clinic's volunteer training and orientation.
"The bottom line is that because of these wonderful volunteers and their dogs, the cost for the program is zero dollars," Skaran says. "But the benefits to patients and their families are priceless."
Journalists can become a member of the Mayo Clinic News Network for the latest health, science and research news and access to video, audio, text and graphic elements that can be downloaded or embedded.
Posted on September 3rd, 2013 by Paul Scotti
JACKSONVILLE, Fla. — Mayo Clinic and the University of North Florida are honoring National Breast Cancer Awareness Month in October by hosting the ninth annual Upbeat Pink: A Musical Tribute to Breast Cancer Survivorship concert at 7:30 p.m. Friday, Oct. 11, at Lazzara Performance Hall on the university's campus in Jacksonville. The Upbeat Pink concert is free and open to the public.
The concert features the UNF Wind Symphony, conducted byGordon Brock, D.M.A and several guest ensembles. The theme for this year's program is "An Evening with James Bond and Friends" featuring songs from the past 50 years of this popular film series.
The Upbeat Pink musical tribute is a prelude to the seventh annual26.2 with Donna: The National Marathon to Finish Breast Cancerscheduled for Feb. 23, 2014 in Jacksonville Beach. The marathon is the first devoted exclusively to raising funds for breast cancer research. The Donna Foundation will again donate a majority of the proceeds from the marathon to Mayo Clinic for breast cancer research. The 2013 event attracted more than 10,000 runners from around the world.
Posted on August 23rd, 2013 by mayonewsreleases
MULTIMEDIA ALERT: For audio and video of Sahra Borges, Ph.D., talking about the study, visit the Mayo Clinic News Network.
JACKSONVILLE, Fla. — A drug used to treat blood cancers may also stop the spread of invasive breast cancer, researchers at Mayo Clinic in Florida have discovered. Their study, published online in Breast Cancer Research, found that in the lab and in animals, the drug decitabine turns on a gene coding for protein kinase D1 (PRKD1) that halts the ability of cancer cells to separate from a tumor and spread to distant organs.
"Treatment with low doses of decitabine in an animal model of breast cancer restored PRKD1 expression, reduced tumor size, and blocked metastasis to the lung," says the study's senior investigator, Peter Storz, Ph.D., a biochemist and molecular biologist at Mayo Clinic in Florida.
"The outcome of patients with invasive breast cancer is less than optimal despite many attempts to improve treatment, including advanced chemotherapy and hormonal therapy," says Dr. Storz. "We hope this study offers a new avenue to prevent breast cancer from becoming aggressive and untreatable."
The research team, which includes first author Sahra Borges, Ph.D., a postdoctoral researcher in Dr. Storz's lab, found that the gene coding for PRKD1 was silenced in all but one subtype of invasive breast cancer, including aggressive triple negative breast cancer. That subtype is invasive lobular carcinoma.
Dr. Borges also developed an assay that can be used to measure the amount of PRKD1 that is silenced in patients' breast tumors.
"Because we found that PRKD1 is increasingly silenced as breast cancer becomes aggressive and spreads, the hope is that this test can be further developed and used to predict which patients are at risk for cancer metastasis, and thus may benefit from decitabine," Dr. Borges says.
Decitabine, approved by the U.S. Food and Drug Administration for use in some blood cancers, is a demethylating agent, meaning that it can switch on beneficial genes such as PRKD1 that cancer has silenced in order to grow.
Treating genes that are silenced is much easier than trying to restore function of a mutated gene, Dr. Storz says. The normal function of PRKD1, which is expressed in cells of the mammary gland, is to maintain normal function by preventing cells from morphing into a state where they can dislodge and spread, he says.
The researchers hope this study will help them to design a clinical trial in collaboration with Mayo Clinic physicians using decitabine to promote re-expression of PRKD1 and agents that activate PRKD1.
The study's other key researchers at Mayo include Heike Doeppler, Edith Perez, M.D., Cathy Andorfer, Ph.D., Zhifu Sun, M.D., Panos Anastasiadis, Ph.D., E. Aubrey Thompson, Ph.D., and Xochiquetzal J. Geiger, M.D. The study was supported by the National Institutes of Health (GM086435), the Bankhead-Coley Program of the Florida Department of Health, Mayo Clinic Breast Cancer SPORE, Breast Cancer Foundation, and from the 26.2 with Donna Foundation.
Posted on August 20th, 2013 by mayonewsreleases
JACKSONVILLE, Fla. — You have a serious medical condition, but conventional tests fail to find an answer. You have no diagnosis and no effective treatment. What do you do? Mayo Clinic has always been a destination for patients seeking answers. Now, Mayo is taking that concept to the next level with the public launch of its Individualized Medicine Clinic at its Florida campus.
To help Mayo Clinic physicians and researchers usher in a new age of medicine that uses technologies like whole genome sequencing to find solutions for patients, Amelia Island, Fla., residents and philanthropists Cecilia and Dan Carmichael have donated $5 million to Mayo.
"If our daughter or our granddaughters were to get cancer, hopefully it could be cured immediately and there would not be this thing hanging over them that any time it could come back," Cecilia Carmichael says.
"It's really an exciting time," Dan Carmichael says. "We want to support the Mayo staff that we've gotten to know and love in transforming care for our family and others."
The Mayo Clinic Individualized Medicine Clinic offers two types of consulting: one for cancer patients for whom standard treatments have failed, and one for "diagnostic odyssey" cases — complex or mysterious disorders that are difficult to diagnose, but appear to have a genetic cause.
"We are leveraging innovative genomic technologies so our physicians can understand a patient's disease at its most fundamental level and use that information to find answers specific to that patient's needs," says Alexander Parker, Ph.D., an epidemiologist and Florida-based associate director of the Mayo Clinic Center for Individualized Medicine.
A multidisciplinary team of experts will work closely with patients and their physicians to determine whether a patient is a good candidate for tests to identify genetic alterations that could help guide treatment. The team includes physicians trained in genomics, genomic scientists, genetic counselors, bioinformatics experts, laboratory professionals and bioethics representatives.
"We are very grateful for the Carmichaels' gift, which is accelerating the translation of genomics to patient care," Dr. Parker says. "Their generosity is helping us move from talking about the promise of genomic medicine to making it a reality for patients."
The Carmichaels' $5 million donation establishes the Cecilia and Dan Carmichael Family Associate Director for the Center of Individualized Medicine in Florida, as well as the Cecilia and Dan Carmichael Family Fund for Individualized Breast Cancer Medicine Honoring Edith Perez, M.D. The donation builds upon the Carmichael's previous generosity. In 2008, they established the Mayo Clinic Carmichael Family Endowed Fund for Individualized Breast Cancer Medicine and also provided funds for an assistant to Dr. Perez in the Breast Clinic at Mayo Clinic.
Posted on August 5th, 2013 by mayonewsreleases
JACKSONVILLE, Fla. — Researchers at Mayo Clinic in Florida have revealed the process by which chronic inflammation of the pancreas, pancreatitis, morphs into pancreatic cancer. They say their findings point to ways to identify pancreatitis patients at risk of pancreatic cancer and to potential drug therapies that might reverse the process.
MULTIMEDIA ALERT: For audio and video of Geou-Yarh Liou, Ph.D. discussing this study, visit the Mayo Clinic News Network.
The study, published online today in The Journal of Cell Biology, maps how inflammation pushes acinar cells in the pancreas — those that produce digestive enzymes — to transform into duct-like cells. As these cells change, they can acquire mutations that can result in further progression to pancreatic cancer, says senior author Peter Storz, Ph.D., a biochemist and molecular biologist at Mayo Clinic.
"We don't know why these cells reprogram themselves, but it may be because producing enzymes in an organ that is injured due to inflammation may cause more damage," Dr. Storz says. "The good news, however, is that this process is reversible, and we identified a number of molecules involved in this pathway that might be targeted to help push these new duct-like cells back into acinar cells, thus eliminating the risk of cancer development."
The scientists are testing the ability of drugs already on the market to reverse this cellular transformation in the pancreas in mice models of human pancreatic cancer. Dr. Storz's research team traced the pathway leading from inflammation in the pancreas to development of cancer in the organ. They followed what happened once macrophages responded to an inflamed pancreas. Macrophages are a type of white blood cell that eats foreign material in the body.
"The belief in the field has been that macrophages were there to remove damaged cells in the organ," Dr. Storz says. "We found they weren't that benign. In fact, we discovered macrophages themselves drive the transformation and provide the setting for development of cancer."
The research team also discovered that if the pancreas is inflamed, fluid from the pancreas contains signaling molecules that induce acinar cells to transform into duct-like cells. Study co-author Massimo Raimondo, M.D., a gastroenterologist, is part of a Mayo team that has developed a method to collect this fluid from the pancreas during a routine upper endoscopy test.
"We want to also investigate whether these two enzymes can serve as an early warning system, a marker of pancreatic cancer risk, in patients with pancreatitis," Dr. Storz says.
"Our hope is that we can detect that risk before cancer happens, and use a treatment that reverses any possibility that pancreatic cancer will develop," he says.
Co-authors include Geou-Yarh Liou, Ph.D., Heike Doeppler, Brian Necela, Ph.D., Murli Krishna, M.D., and Howard Crawford, Ph.D.
As a leading institution funded by the National Cancer Institute, Mayo Clinic Cancer Center conducts basic, clinical and population science research, translating discoveries into improved methods for prevention, diagnosis, prognosis and therapy. For information on cancer clinical trials, call 507-538-7623.
Posted on July 19th, 2013 by mayonewsreleases
PENSACOLA, Fla. — Baptist Health Care based in Pensacola is the most recent member of the Mayo Clinic Care Network, representatives from Mayo Clinic and BHC announced today. The Mayo Clinic Care Network shares Mayo Clinic's knowledge and expertise with physicians and providers interested in working together to enhance the delivery of health care for their patients. Baptist providers now have access to Mayo Clinic resources, including its online point-of-care information system and electronic consulting process that connects physicians with Mayo Clinic specialists on questions of diagnosis, therapy or care management.
Baptist is the first organization in the region to join the Mayo Clinic Care Network. The organization remains the area's only locally owned, not-for-profit health care system, providing services across northwest Florida and south Alabama.
"Through this relationship, Baptist and Mayo Clinic share a desire to improve the delivery of health care throughout the region with high-quality, evidence-based medical care and treatment," said Mark Faulkner, president and CEO of Baptist Health Care. "Working together, we can treat an increasing number of patients closer to home."
Baptist underwent a thorough review process based on quality, service and operational criteria. The assessment confirmed the commitment Baptist shares with Mayo Clinic in improving the delivery of health care. Baptist's membership is a direct result of its culture and dedication to providing compassionate patient care.
"Baptist is the established, premier health care provider in the region, and by working together through the care network we can accelerate innovative patient care even more," says Stephen Lange, M.D., Southeast medical director of the Mayo Clinic Care Network. "Through this collaboration, patients in the Pensacola area will have access to top providers at Baptist, and also benefit from the leading expertise of specialists at Mayo Clinic."
Baptist physician experts will be able to connect with those at Mayo Clinic on questions of complex medical care using an electronic consulting technique called eConsults. They also will have 24/7 access to Mayo-vetted medical information and guidelines through AskMayoExpert, a Web-based resource created for physicians and other health care providers. These tools, in addition to health care consulting related to clinical and business processes, will allow staff at Baptist to continue to provide the best care for its patients as well as support the organization's mission to improve the quality of health in the community.
Baptist Health Care employs more than 6,700 and is the largest non-government employer in the region. The organization has a strong alignment with more than 700 health care providers — 131 of whom are employed by Baptist.
The Mayo Clinic Care Network represents non-ownership relationships. With Mayo Clinic, members of the network share a commitment to improve the quality and delivery of health care. The primary goal of the Mayo Clinic Care Network is to help people gain the benefits of Mayo Clinic knowledge and expertise close to home, ensuring that patients need to travel for care only when necessary.
The network launched in 2011, and has member organizations based in Arizona, Florida, Illinois, Kentucky, Michigan, Minnesota, Missouri, Montana, New Hampshire, North Dakota, Puerto Rico and Mexico.
For more information about Baptist's collaboration with Mayo Clinic, please call 850-434-4080 or visit Baptist Health Care online.
Baptist Health Care is a community-owned, not-for-profit health care organization committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization is a proud a member of the Mayo Clinic Care Network. A 2003 Malcolm Baldrige recipient, Baptist continuously strives to be a national leader in quality and service. Baptist Health Care includes four hospitals, two medical parks, Baptist Manor, Baptist Leadership Group, Andrews Institute for Orthopaedic & Sports Medicine, Lakeview Center, Baptist Medical Group, Cardiology Consultants. With more than 6,700 employees and employed physicians, Baptist Health Care is the largest non-governmental employer in northwest Florida.
Baptist Health Care | Baptist Hospital | Gulf Breeze Hospital | Jay Hospital | Atmore Community Hospital | Lakeview Center | Baptist Manor | Baptist LifeFlight | Baptist Medical Park – Nine Mile | Baptist Medical Park – Navarre | Andrews Institute | Baptist Medical Group | Cardiology Consultants | Baptist Leadership Group | Mayo Clinic Care Network
Posted on July 16th, 2013 by mayonewsreleases
JACKSONVILLE, Fla. — U.S. News & World Report has again named Mayo Clinic's campus in Jacksonville to its annual list of America's Best Hospitals published online today. Mayo Clinic tied for the No. 1 spot in the Jacksonville metro area and the No. 4 spot in Florida. Mayo Clinic also is ranked nationally among the top 50 hospitals in cancer (#34).
Mayo Clinic's Jacksonville campus also was recognized as high performing in diabetes and endocrinology, ENT, gastroenterology and GI surgery, geriatrics, gynecology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology.
"This honor reflects the deep commitment of our staff to provide the highest quality of care to our patients every day," says William Rupp, M.D., chief executive officer at Mayo Clinic. "Our employees are critical to the success of Mayo Clinic. I'm extremely grateful for their dedication and commitment to making the patient experience the very best it can be."
To rank the best hospitals, U.S. News analyzes data for more than 5,000 medical centers.
Mayo Clinic's campus in Rochester, Minn., earned the No. 3 overall spot on the "Best Hospitals" list and took the No. 1 spot in Minnesota. Mayo Clinic's campus in Arizona was ranked No. 1 in that state and in the Phoenix metro area.
The rankings were announced on the U.S. News & World Report website. Print versions of the guidebook edition will be on sale Aug. 27.
Posted on July 15th, 2013 by mayonewsreleases
JACKSONVILLE, Fla. — Mayo Clinic's new primary care center near the intersection of Gate Parkway and the I-295 East Beltway opens today.
"Mayo Clinic is expanding primary care services to meet patients' needs, improve access and bring primary care closer to where our patients live," says John Presutti, D.O., the medical director for Mayo Clinic's three freestanding primary care centers.
The two-story, 40,000-square-foot, $16.7 million center is located at 7826 Ozark Drive in the fast-growing Hampton Village area. The center will open with five physicians and an advanced registered nurse practitioner, but it is built to eventually accommodate more than 20 care providers. The center is supported by about 30 full- and part-time allied health staff.
This is the first new freestanding primary care center that Mayo Clinic has built in 16 years. The Mayo Clinic Primary Care Center in St. Augustine opened in 1997; the center at the Beaches opened in 1995.
The new center has family medicine and sports medicine physicians who provide care to patients of all ages, including infants, adolescents and adults. On-site radiology and laboratory services will provide X-ray, mammography, ultrasound and basic tests.
The center's hallmark is team-based care with access to Mayo Clinic specialists when a patient needs it. The center offers extended hours: 7 a.m. to 7 p.m. Monday through Thursday, 7 a.m. to 5:30 p.m. Friday, and 8 a.m. to noon Saturday.
"The expansion is not only helping Mayo Clinic meet patients' needs, it's a natural extension of adopting health care reform, which is placing a greater emphasis on primary care and the concept of a patient-centered medical home," Dr. Presutti says.
"The medical home concept emphasizes coordination, whole-person orientation and partnerships between patients and their care providers," he says. "Mayo Clinic's team-based primary care and specialty medicine, experience with collaboration, and advanced use of a single electronic medical record makes it ideal to nurture the concept."
Posted on May 29th, 2013 by mayonewsreleases
JACKSONVILLE, Fla. — Devices snaked into the brain artery of a patient experiencing a stroke that either snatch and remove the offending clot or pump a dissolving drug into the blockage should primarily be used within a clinical trial setting, say a team of vascular neurologists at Mayo Clinic in Florida.
VIDEO ALERT: Video of Dr. Barrett and related stroke content is available on the Mayo Clinic News Network.
In a commentary published in the May 29 issue of Mayo Clinic Proceedings, the physicians say the devices, known collectively as endovascular stroke therapy, should predominantly be limited to use within clinical trials. This is necessary, they say, in order to determine which patients might benefit from use of these devices, and what the risks of such interventional procedures are, when compared to the current standard of care for ischemic stroke. Ischemic stroke, the most common form of stroke, results from a blockage that restricts blood flow in the brain.
A growing number of physicians who treat stroke are currently using these tools, so the recommendation to limit their use to clinical trials will be controversial, acknowledges Kevin Barrett, M.D., co-medical director of Mayo Clinic's Primary Stroke Center in Florida.
"Continued use of endovascular stroke therapy outside of clinical trials will further delay the potential to identify those patients who are most likely to benefit with an acceptable risk profile," Dr. Barrett says. "Using them as part of routine clinical practice without studying their effectiveness in a controlled setting will limit advances in the science of stroke treatment."
The commentary is meant to provide perspective and address questions that arose following the March 7 publication of a study in The New England Journal of Medicine. That report concluded that endovascular therapy used after standard stroke therapy — recombinant tissue plasminogen activator (rtPA) — offered similar safety outcomes and no significant difference in benefit to use of rtPA alone. The study was based on results of a 656-patient trial, known as the Third Interventional Management of Stroke (IMS III).
Use of rtPA has been the standard of care since 1996. The drug, given intravenously, binds to clots and dissolves them to restore blood flow. But it must be used within 3–4.5 hours of the onset of symptoms of a stroke. For patients who present too late to be safely treated with rtPA or have a contraindication to the drug, endovascular therapy is often offered as an alternative treatment strategy at centers with expertise in intra-arterial stroke treatment.
IMS III tested use of several endovascular treatment approaches in following administration of intravenous rtPA. One is the Merci catheter, the first mechanical clot-removing device to be approved (in 2004) by the U.S. Food and Drug Administration. At the time of approval, there was no published evidence that the device was superior to use of intravenous rtPA alone, Dr. Barrett says. The corkscrew-type device is threaded to the brain through the femoral artery in the groin, and it grabs and removes the clot blockage. The other frequently used approach was rtPA delivered directly to the blood clot from within the artery.
Criticisms of IMS III include the infrequent use of newer generation endovascular devices. These devices use a catheter to deliver a retrievable stent that snatches the clot and removes it. "The difference between use of stents for acute stroke and use of stents for blocked heart arteries is that cardiovascular stents are permanently deployed within the artery," Dr. Barrett says.
"Our conclusion is that the sum of evidence, at this point, is that rtPA should remain the standard of care in patients who can be treated between three and 4.5 hours after stroke onset and endovascular stroke therapy should be used within the context of a clinical trial whenever possible," Dr. Barrett says.
Not only has endovascular therapy not shown to offer greater clinical benefit than rtPA, the speed by which these devices can be used is a concern, given the results of IMS III, he adds.
Mayo Clinic in Florida offers several endovascular clinical trials to stroke patients, including a protocol called EARLY that randomizes patients to intravenous rtPA or ultra-early primary endovascular therapy. "We think endovascular therapy likely has a role in acute stroke therapy, but we haven't yet identified the group of patients who will most benefit from it," Dr. Barrett says. "The only way we will get those answers is with well-designed prospective studies."