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, March 2, 2024

Comparison between transradial and transfemoral mechanical thrombectomy for ICA and M1 occlusions: insights from the Stroke Thrombectomy and Aneurysm Registry (STAR)

Since you didn't tell us how many 100% recovered, your research was essentially worthless. No measurement of that, you don't know what survivors want, do you? The only goal in stroke is 100% recovery and you did nothing to get there!

“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest here:

 Comparison between transradial and transfemoral mechanical thrombectomy for ICA and M1 occlusions: insights from the Stroke Thrombectomy and Aneurysm Registry (STAR)
  1. Michael A Silva1,
  2. Sameh Samir Elawady2,
  3. Ilko Maier3,
  4. Sami Al Kasab4,
  5. Pascal Jabbour5,
  6. Joon-Tae Kim6,
  7. Stacey Q Wolfe7,
  8. Ansaar Rai8,
  9. Marios-Nikos Psychogios9,
  10. Edgar A Samaniego10,
  11. Nitin Goyal11,
  12. Shinichi Yoshimura12,
  13. Hugo Cuellar13,
  14. Jonathan A Grossberg14,
  15. Ali Alawieh15,
  16. Ali Alaraj16,
  17. Mohamad Ezzeldin17,
  18. Daniele G Romano18,
  19. Omar Tanweer19,
  20. Justin Mascitelli20,
  21. Isabel Fragata21,
  22. Adam J Polifka22,
  23. Fazeel M Siddiqui23,
  24. Joshua W Osbun24,
  25. Roberto Javier Crosa25,
  26. Charles Matouk26,
  27. Michael R Levitt27,
  28. Waleed Brinjikji28,
  29. Mark Moss29,
  30. Travis M Dumont30,
  31. Richard Williamson31,
  32. Pedro Navia32,
  33. Peter Kan33,
  34. Reade Andrew De Leacy34,
  35. Shakeel A Chowdhry35,
  36. Alejandro M Spiotta2,
  37. Min S Park36,
  38. Robert M Starke1
  39. STAR Collaborators
  1. Correspondence to Dr Michael A Silva, Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; mas633@miami.edu

Abstract

Background The role for the transradial approach for mechanical thrombectomy is controversial. We sought to compare transradial and transfemoral mechanical thrombectomy in a large multicenter database of acute ischemic stroke.

Methods The prospectively maintained Stroke Thrombectomy and Aneurysm Registry (STAR) was reviewed for patients who underwent mechanical thrombectomy for an internal carotid artery (ICA) or middle cerebral artery M1 occlusion. Multivariate regression analyses were performed to assess outcomes including reperfusion time, symptomatic intracerebral hemorrhage (ICH), distal embolization, and functional outcomes.

Results A total of 2258 cases, 1976 via the transfemoral approach and 282 via the transradial approach, were included. Radial access was associated with shorter reperfusion time (34.1 min vs 43.6 min, P=0.001) with similar rates of Thrombolysis in Cerebral Infarction (TICI) 2B or greater reperfusion (87.9% vs 88.1%, P=0.246). Patients treated via a transradial approach were more likely to achieve at least TICI 2C (59.6% vs 54.7%, P=0.001) and TICI 3 reperfusion (50.0% vs 46.2%, P=0.001), and had shorter lengths of stay (mean 9.2 days vs 10.2, P<0.001). Patients treated transradially had a lower rate of symptomatic ICH (8.0% vs 9.4%, P=0.047) but a higher rate of distal embolization (23.0% vs 7.1%, P<0.001). There were no significant differences in functional outcome at 90 days between the two groups.

Conclusions Radial and femoral thrombectomy resulted in similar clinical outcomes. In multivariate analysis, the radial approach had improved revascularization rates, fewer cases of symptomatic ICH, and faster reperfusion times, but higher rates of distal emboli. Further studies on the optimal approach are necessary based on patient and disease characteristics.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/jnis-2023-021358

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