Deans' stroke musings: Outcomes after Thrombectomy for Minor Stroke: A Meta-Analysis

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.

Saturday, December 26, 2020

Outcomes after Thrombectomy for Minor Stroke: A Meta-Analysis

Bad research, not measuring 100% recovery.

https://doi.org/10.1016/j.wneu.2020.12.047 Get rights and content

Abstract

Purpose

The purpose of this study was to determine the outcomes after mechanical thrombectomy (MT) versus medical management in patients with minor stroke symptomatology.

Methods

A meta-analysis was performed for studies reporting outcomes after mechanical thrombectomy, either as stand-alone therapy or with intravenous thrombolysis (IVT) in patients with minor stroke with LVO.

Results

Fourteen studies with 2,134 patients met the selection criteria and were included. Two studies compared immediate thrombectomy (IMT) versus best medical management (with rescue thrombectomy) and the ORs of excellent outcomes, good outcomes, mortality and incidence of sICH after IMT vs BMM were 1.07 (95% CI: 0.93 – 1.22%),1.15 (95% CI 1.05 – 1.25), 0.65 (95% CI 0.30 – 1.38), and 2.89 (95% CI: 0.82 – 10.13) respectively. Among the 8 studies that compared mechanical thrombectomy (MT) outcomes versus medical management (without thrombectomy), ORs of excellent outcomes, good outcomes, mortality and incidence of sICH after MT vs MM were 0.98 (95% CI: 0.89 – 1.07), 0.94 (95% CI: 0.89 – 1.00), 1.61 (95% CI: 1.08 – 2.41), and 2.59 (95% CI: 1.35 – 4.96) respectively. Among all 14 studies, pooled proportions of excellent outcomes, good outcomes, mortality and sICH after thrombectomy were 58.7%, 76.2%, 6.82%, and 3.23% respectively.

Conclusion

Our study shows significant selection bias and heterogeneity in the literature with differences in baseline characteristics (age, stroke severity, pre-stroke mRS, side of infarct, vessel and site of occlusion, use of IVT, criteria for clinical deterioration and selection bias for rescue MT and rates of reperfusion), emphasizing the need for a randomized controlled trial.