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.

Sunday, June 28, 2020

Stroke Treatment Delay Limits Outcome After Mechanical Thrombectomy: Stratification by Arrival Time and ASPECTS

Are you THAT FUCKING CLUELESS that you think survivors just want functional independence? Just maybe if you actually talk to survivors you will find out they want 100% recovery.  NOT your fucking tyranny of low expectations, 'functional independence' or 'good outcomes'.

Stroke Treatment Delay Limits Outcome After Mechanical Thrombectomy: Stratification by Arrival Time and ASPECTS

First published: 27 June 2020
https://doi.org/10.1111/jon.12729
Acknowledgements and Disclosures: : None of the authors has relevant disclosures.


ABSTRACT


BACKGROUND AND PURPOSE

Mechanical thrombectomy (MT) has helped many patients achieve functional independence. The effect of time‐to‐treatment based in specific epochs and as related to Alberta Stroke Program Early CT Score (ASPECTS) has not been established. The goal of the study was to evaluate the association between last known normal (LKN)‐to‐puncture time and good functional outcome.(My definition of good is 100% recovery. What the hell is yours?)

METHODS

We conducted a retrospective cohort study of prospectively collected acute ischemic stroke patients undergoing MT for large vessel occlusion. We used binary logistic regression models adjusted for age, Modified Treatment in Cerebral Ischemia score, initial National Institutes of Health Stroke Scale, and noncontrast CT ASPECTS to assess the association between LKN‐to‐puncture time and favorable outcome defined as Modified Rankin Score 0‐2 on discharge.

RESULTS

Among 421 patients, 328 were included in analysis. Increased LKN‐to‐puncture time was associated with decreased probability of good functional outcome (adjusted odds ratio [aOR] ratio per 15‐minute delay = .98; 95% confidence interval [CI], .97‐.99; P = .001). This was especially true when LKN‐puncture time was 0‐6 hours (aOR per 15‐minute delay = .94; 95% CI, .89‐.99; P = .05) or ASPECTS 8‐10 (aOR = .98; 95% CI, .97‐.99; P = .002) as opposed to when LKN‐puncture time was 6‐24 hours (aOR per 15‐minute delay = .99; 95% CI, .97‐1.00; P = .16) and ASPECTS <8 (aOR = .98; 95% CI, .93‐1.03; P = .37).

CONCLUSION

Decreased LKN‐groin puncture time improves outcome(NOT GOOD ENOUGH) particularly in those with good ASPECTS presenting within 6 hours. Strategies to decrease reperfusion times should be investigated, particularly in those in the early time window and with good ASPECTS.

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