Deans' stroke musings: Faster reperfusion following stroke may yield better outcomes

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, February 11, 2013

Faster reperfusion following stroke may yield better outcomes

I stand by my estimate that reperfusion would need to be done in one minute in order to stop the neuronal cascade of death.
http://www.healio.com/cardiology/stroke/news/online/%7B6ABE24DA-75F4-485F-82A9-44A2107C5465%7D/Faster-reperfusion-following-stroke-may-yield-better-outcomes
Each 30-minute delay leads to a 10% decrease in the probability of a good outcome after angiographic reperfusion with intravenous or intra-arterial therapy, researchers said at the International Stroke Conference 2013.
Pooja Khatri, MD, MSc, director of acute stroke and associate professor of neurology at University of Cincinnati Academic Health Center, and colleagues presented data on a substudy of the IMS III trial. The researchers analyzed 240 patients with ischemic stroke who received both IV and endovascular therapy. Eligible patients were also treated with IV tissue plasminogen activator within 3 hours of stroke onset.

Pooja Khatri

Among these patients, 182 had blood flow restored within 7 hours from stroke onset. Reperfusion was achieved in 76% of patients. Time to reperfusion ranged from 180 minutes to 418 minutes.
Time proved critical regardless of other factors, such as absence of a disability prior to stroke, stroke severity or results of the patients’ scans before treatment, according to a press release.
“Every 30-minute delay in reperfusion was associated with a reduction in good outcome. Time to reperfusion remained an independent and significant predictor of outcomes,” Khatri said at a press conference.
According to Khatri, the importance of timing using endovascular therapy has not been well studied.
“We have effective endovascular treatments for unblocking arteries, but as far as actually making stroke patients clinically better, we need to move a lot faster,” Khatri stated in the release.
“For endovascular therapy to work we may need to deliver it more quickly, and that is what future trials need to test. If we had opened arteries faster in the IMS III trial, we might have had a positive trial that brought a more effective treatment to patients with severe strokes.