MERCI @ UKM Medical Centre
4 September, 2012 1 Comment
A follow on from our previous story.
As previously explained in the previous article, successful and complete stroke reversal is possible if a patient is given treatment within 4.5 hours. A stroke victim can have the attack reversed and have a complete recovery when treated with an anti clotting drug which dissolves the blood clot in the brain.
In cases where the patient did not receive treatment within the said 4.5 hours, a different approach is required. At the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Cheras, Kuala Lumpur patients in this situation can be treated using the MERCI device. Radiologists at UKMMC are trained to trained to rescue patients attacked by stroke due to blood clot by physically pulling the clot out from the blood vessel in the brain.
At UKMMC, stroke patients who had not had treatment within 4 hours of a stroke are referred to the radiologist by the UKMMC Stroke Team, without the need to wait for a neurologist.
“Between four and a half and 6 hours, there is still a window of opportunity where the radiologists will try to rescue the patient by removing the clot. This is done by inserting a catather into the blood vessel and pulling the clot out using the MERCI device,” said Prof. Dato’ Dr. Raymond Azman Ali, the Senior Consultant Neurologist.
The MERCI device consists of a catheter with cork-screw shaped device at the end. The device wraps around the clot and traps it. In this case the cork screw shaped retriever will travel all the way up to the brain to retrieve the blood clot.
Once the catheter is deployed and in position, the corkscrew shaped device will engage the blood clot, grab it very slowly, trap it and pull it out all the way down back to the groin.
The MERCI device can also be used on patients who cannot be given the anti-clotting drug Recombinant Tissue Plasminogen Activator or r-tPA.
Here a Youtube video on the procedure using the Concentric Medical MERCI device.
The Merci Retriever was first cleared for human use in 2004 by the FDA. Since 2004, the Merci Retriever has been used in more than 14,000 patients throughout the world (Concentric Medical website)
Adapted from “UKM radiologists trained to rescue Stroke Patient with MERCI” first published 22 SEPTEMBER 2010 here.
Editor’s Note :
Prof. Dato’ Dr. Raymond Azman Ali is an MRSM Seremban Alumni (Batch 72). He is currently the Dean of the Medical Faculty and the Director of the UKM Medical Centre (Dekan Fakulti Perubatan & Pengarah Pusat Perubatan UKM)