PRAAN study unveils outcomes of multi-centric prospective stroke registry on mechanical thrombectomy in India

Results from the Prospective Registry for Assessment of Acute Ischemic Stroke Patients Treated with stroke Devices in India (PRAAN) were unveiled at the World Stroke Congress 2024, held in Abu Dhabi. PRAAN is an industry-sponsored dedicated registry on mechanical thrombectomy, collecting real-world data on the use of stroke devices in patients with acute ischemic stroke (AIS) caused by large vessel occlusion.

The multi-centre study evaluates the clinical outcomes associated with market-released stroke devices of Medtronic for AIS patients with large vessel occlusion conditions. The PRAAN registry enrolled 200 patients over 24 months, across 14 centres, and demonstrated that mechanical thrombectomy is a safe, effective, as well as cost-effective treatment for AIS in India.

In India, approximately 1.18 million patients experience stroke annually, with around 21 per cent being suitable for mechanical thrombectomy procedures. Mechanical thrombectomy is a minimally invasive surgery to remove the brain clot. The current adoption rate of mechanical thrombectomy is less than 0.1 per cent in India, generally owing to a lack of awareness and access. The PRAAN study aims to bridge this gap by providing real-world data to healthcare professionals and policymakers, thus enabling them to strengthen stroke management in India by improving accessibility and adoption.

The data from the PRAAN study demonstrated high rates of positive functional outcomes and procedural success of mechanical thrombectomy with a low mortality rate in AIS patients. Additionally, the health economic analysis revealed that mechanical thrombectomy (MT) alone or in combination with intravenous tissue plasminogen activator (IV-tPA) appears to be cost-effective compared to IV-tPA treatment alone.

Highlights of the outcomes from the PRAAN Study

• The results from the study are comparable to the global clinical registries and randomised clinical trials.
• The success rate of revascularization, which means clearing a blood clot and getting blood flowing again in the vessel, is 87.4 per cent after the final attempt.
• After 90 days following the procedure, 65.8 per cent of the patients had little or no disability.                                    
• MT treatment is cost-effective as it helps people live better lives following a stroke. Patients treated with MT improved more after 90 days than those who only got IV-tPA treatment

Dr Mathew Cherian, HOD Intervention Radiology at KMCH, Coimbatore, said, “A cerebral infarction caused by a blockage in the brain’s blood vessels can result in permanent disability or death. However, thanks to mechanical thrombectomy, patients now have a treatment option available that can enable them to regain their mobility and resume their day-to-day activities. A recent multi-centre trial conducted in India by Medtronic has once again proven the remarkable effectiveness of this groundbreaking stroke treatment in India.”

Dr Vikram Huded, Director and Clinical Lead, Interventional Neurology Programme of NH group, Head of Neurology, Narayana Health, Bengaluru, commented,” Stroke is a medical emergency impacting millions of lives. Mechanical thrombectomy is a revolutionary treatment that has increased the treatment window up to 24 hours since the onset of symptoms in stroke. However, it is important to assess the impact of the procedure on the Indian patient pool and for that, Medtronic has conducted the PRAAN study in India. The study has demonstrated good clinical outcomes like 65.8 per cent had mRS score between 0-2 at 90 days follow-up which provides us the assurance about the efficacy of MT among Indian patients.”