Montpellier University Hospital: progress on stroke published in the New England Journal of Medicine

Montpellier University Hospital: progress on stroke published in the New England Journal of Medicine
Montpellier University Hospital: progress on stroke published in the New England Journal of Medicine


Valentina Volle

Published on

May 15, 2024 at 8:31 a.m.

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The brain, intriguing and complex organ, still holds well mysteries for science and medicine. A team of researchers at Montpellier University Hospitalled by the Professor Vincent Costalatneuroradiologist, and the Dr Caroline Arquizanneurologist, has just made a revolutionary discovery in the field of treatment of stroke.

Their study, published in the world’s most prestigious medical journal New England Journal of Medicineopens new perspectives in the treatment of this pathology.

“The brain we thought was dead”

Since the validation of brain revascularization techniques In 2015, stroke doctors focused on patients with limited brain damage. It was then considered that only brain tissue not affected by the stroke could be saved, the rest being irremediably lost. However, it is quite the opposite that the Montpellier University Hospital teams demonstrated.

What is stroke?

A stroke is either the blockage or rupture of a blood vessel in the brain. It is the sudden loss of one or more brain functions. It can occur at any age in adults. Due to the risk of irreversible damage to the brain, this is an absolute medical emergency which requires calling 15 (Samu) or the European emergency number (112) for immediate treatment.

“Surprising and strongly positive” results

“We are very proud of our teams but also of having been able to bring together almost all French university hospitals on this initiative, resulting in a change in medical practice around the world. The IN EXTREMIS study continues to develop in Spain, but also in the United States, to continue to push the limits of current indications for treatment by mechanical revascularization of stroke”

Doctors Caroline Arquizan and Vincent Costalat

The CHU research center has promoted a multicenter therapeutic trial “In extremis-laste”conducted in France and in Spain coordinated by Professor Vincent Costalat and Dr Caroline Arquizan, in collaboration with Dr Bertrand Lapergue (Hôpital Foch, Paris) and Professor Tudor Jovin (Cooper, University Hospital, NJ, United States).

The objective of this study was to select patients say “ too severe » or considered as “ irrecoverable » in daily practice, and to test the hypothesis that a reperfusion of brain tissue considered dead could change their vital prognosis but also their functional recovery.

To the great surprise of the entire international medical scientific community, the therapeutic trial, carried out on 333 patients included in France and Spain, proved strongly positive with a reduction in absolute risk of death by 20% and a surprising functional improvement allowing bring one in five patients home after six months of rehabilitation.

Research at the University Hospital

“The results of this study are major and demonstrate the ability of our doctors and researchers to conduct very high-level research for the benefit of patients. Multidisciplinarity and excellence of practices explain this aptitude for innovation. »

Anne Ferrer, General Director, highlights the performance of the Montpellier University Hospital in terms of research, particularly within the Head and Neck Neuroscience center

At the forefront in multiple sectors, Montpellier University Hospital plays a key role in research and innovation, which ranks sixth nationally in terms of publications and fifth in terms of inclusion of patients in clinical trials, with nearly 1,700 protocols in progress. The values ​​of “ humanity, equality, solidarity and responsibility » guide the CHU teams in their daily mission of patient care and innovation.

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This major breakthrough opens the way to a new paradigm in understanding the pathophysiology of strokethe organization of neuronal death and the recovery capacities of brain tissue in the acute phase of a stroke, which also underlines the importance of international collaboration in medical research.

Another international study “In extremis-moste”, also promoted by the Montpellier University Hospital, is already well advanced with the participation of the same French and Spanish centers and for the first time from American centers.

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