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, July 11, 2021

Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee

Just so you understand that their definition of effective doesn't correspond to any survivors definition; 100% recovery. They think reperfusion is effective; IT'S NOT BY ANY STRETCH OF FACTUAL BASIS.  Until WE change the discussion to 100% recovery we will always get crapola like this.

 Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee

  1. Fawaz Al-Mufti1,
  2. Clemens M Schirmer2,
  3. Robert M Starke3,
  4. Neeraj Chaudhary4,
  5. Reade De Leacy5,
  6. Stavropoula I Tjoumakaris6,
  7. Neil Haranhalli7,
  8. Isaac Josh Abecassis8,9,
  9. Krishna Amuluru10,
  10. Ketan R Bulsara11,
  11. Steven W Hetts12
  12. On behalf of the SNIS Standards and Guidelines Committee and SNIS Board of Directors
  1. Correspondence to Dr Steven W Hetts, Department of Radiology, UCSF, San Francisco, CA 94143, USA; steven.hetts@ucsf.edu

Abstract

Background The purpose of this guideline is to summarize the data available for performing mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) stroke in special populations not typically included in large randomized controlled clinical trials, including children, the elderly, pregnant women, patients who have recently undergone surgery, and patients with thrombocytopenia, collagen vascular disorders, and endocarditis.

Methods We performed a literature review for studies examining the indications, efficacy, and outcomes for patients undergoing MT for ischemic stroke aged <18 years and >80 years, pregnant patients, patients who have recently undergone surgery, and those with thrombocytopenia, collagen vascular diseases, or endocarditis. We graded the quality of the evidence.

Results MT can be effective for the treatment of ELVO in ischemic stroke for patients over age 80 years and under age 18 years, thrombocytopenic patients, pregnant patients, and patients with endocarditis. While outcomes are worse compared to younger patients and those with normal platelet counts (respectively), there is still a benefit in the elderly (in both mRS and mortality). Data are very limited for patients with collagen vascular diseases; although diagnostic cerebral angiography carries increased risks, MT may be appropriate in carefully selected patients in whom untreated ELVO would likely result in disabling or fatal outcome.

 

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