Deans' stroke musings: Recanalization therapies in acute ischemic stroke patients

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.

Friday, October 7, 2016

Recanalization therapies in acute ischemic stroke patients

You'll have to ask your doctor what the hell this means. Obviously written to confuse the layperson. And our fucking failures of stroke associations won't put research out in readable form.
http://www.mdlinx.com/internal-medicine/medical-news-article/2015/09/29/anticoagulants-endovascular-procedures-intra-arterial-treatment/6345509/?

The authors explored the safety of intravenous thrombolysis (IVT) or intra–arterial treatment (IAT) in patients with ischemic stroke on non–vitamin K antagonist oral anticoagulants (NOACs, last intake <48 hours) in comparison with patients (1) taking vitamin K antagonists (VKAs) or (2) without previous anticoagulation (no–OAC). IVT/IAT in selected patients with ischemic stroke under NOAC treatment has a safety profile similar to both IVT/IAT in patients on subtherapeutic VKA treatment or in those without previous anticoagulation. However, further prospective studies are needed, including the impact of specific coagulation tests.

Methods

This is a multicenter cohort pilot study. Primary outcome measures were (1) occurrence of intracranial hemorrhage (ICH) in 3 categories: any ICH (ICHany), symptomatic ICH according to the criteria of the European Cooperative Acute Stroke Study II (ECASS–II) (sICHECASS–II) and the National Institute of Neurological Disorders and Stroke (NINDS) thrombolysis trial (sICHNINDS); and (2) death (at 3 months).
Cohorts were compared by using propensity score matching.
The NOAC cohort comprised 78 patients treated with IVT/IAT and the comparison groups of 441 VKA patients and 8938 no–OAC patients.

Results

The median time from last NOAC intake to IVT/IAT was 13 hours (interquartile range, 8–22 hours).
In VKA patients, median pre–IVT/IAT international normalized ratio was 1.3 (interquartile range, 1.1–1.6).
ICHany was observed in 18.4% NOAC patients versus 26.8% in VKA patients and 17.4% in no–OAC patients.
sICHECASS–II and sICHNINDS occurred in 2.6%/3.9% NOAC patients, in comparison with 6.5%/9.3% of VKA patients and 5.0%/7.2% of no–OAC patients, respectively.
At 3 months, 23.0% of NOAC patients in comparison with 26.9% of VKA patients and 13.9% of no–OAC patients had died. Propensity score matching revealed no statistically significant differences.

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