Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, August 8, 2017

The Use and Utility of Aspiration Thrombectomy in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

This is suctioning the clot thru the catheter.You'll have to ask your stroke hospital what system they are using to remove clots and the efficacy of that system. Hopefully before you get to the emergency room. Those statistics should be publicly available so we can boycott those stroke hospitals that aren't any good.
http://www.docguide.com/use-and-utility-aspiration-thrombectomy-acute-ischemic-stroke-systematic-review-and-meta-analysis?hash=7e422beb&eid=59271&alrhash=3c9ebc-5aeefe0d7ed0a73e6788dca4998df39c

Wei D, Mascitelli J, Nistal D, Kellner C, Fifi J, Mocco J, De Leacy R; American Journal of Neuroradiology (AJNR) (Jul 2017)

BACKGROUND Thrombectomy trials are often specifically interpreted as evidence for the effectiveness of stent retrievers. The effectiveness of other thrombectomy techniques such as aspiration thrombectomy should be validated through further investigation and review.
PURPOSE To evaluate published treatment times and clinical outcomes in patients treated with aspiration thrombectomy or ADAPT (A Direct Aspiration, First Pass Technique) for acute ischemic stroke.
DATA SOURCES A systematic literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Scopus, and the Cochrane trial register were searched on November 8, 2016.
STUDY SELECTION Twenty studies (n = 1523 patients) were included in this review and meta-analysis. One of these studies was prospective, and the rest were retrospective.
DATA ANALYSIS Meta-analysis was performed by using a random effects model. Data and publication bias were visualized with forest plots and funnel plots.
DATA SYNTHESIS Five studies investigated aspiration thrombectomy only, and 16 studies investigated ADAPT. Of the 16 studies on ADAPT, the rate of successful recanalization (TICI 2b/3) was 89.3% (95% CI, 85.4%-92.3%). The proportion of patients with good clinical outcome (90-day mRS ≤2) was 52.7% (95% CI, 48.0%-57.4%).
LIMITATIONS Studies on ADAPT were retrospective, and there was heterogeneity between studies for successful recanalization (P<.001) and good clinical outcome (P<.001). There was evidence of publication bias for recanalization rates (P = .01), but not for clinical outcomes (P = .42).
CONCLUSIONS ADAPT and aspiration thrombectomy are effective approaches to thrombectomy, with high recanalization rates and excellent clinical outcomes reported in the literature. Aspiration thrombectomy is a promising neurointervention, but large prospective randomized studies are needed to validate its utility.

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