text_1: Heart Association's Stroke Guidelines Support Clot-Removing Device If clot-busting drugs don't work, device can be used to pull the blockage out through the artery
text_2: A Medtronic device used to remove clots during stroke. This brief article explains why a certain subset of people who have strokes may be treated more effectively with a new procedure than with existing alternatives. The new procedure sends a thin wire tube through their blood vessels to the location of a clot in the brain and removes it. The story did an excellent job of listing the complex criteria required to find the patients for whom this procedure is now recommended. It could have provided more specifics about the benefits associated with the procedure and its costs. And one of the experts tapped for commentary is a paid consultant to companies who make the devices used in this procedure, and the story should have alerted readers to that fact. The new guidelines are the result of months of study by a committee of the American Heart Association. Implementation of these guidelines will require much more systematic coordination of stroke care than currently exists. Currently, smaller community hospitals can quickly assess a patient, get an imaging study, and start tPA (clot-busting medication delivered by IV) within an hour or two after symptoms begin. But to assess eligibility for endovascular clot retrieval (the procedure discussed here), and transport patients to centers that provide the highly specialized procedures, could take time. There is good-quality evidence that such coordination of stroke care would produce clinically important benefits, but the logistical and cost challenges that have yet to be addressed are significant.