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.

Monday, May 13, 2024

Endovascular therapy improved ischemic stroke outcomes at 1 year

 You do realize survivors want full recovery, not just improved outcomes? Or haven't you ever talked to a survivor without informing them of your tyranny of low expectations? I'd fire everyone involved since there was NO measurement of 100% recovery!

Endovascular therapy improved ischemic stroke outcomes at 1 year 

Key takeaways:

  • The study examined 352 individuals with stroke randomized to EVT and medical care or medical care alone.
  • EVT intervention led to improved functional independence and better ambulation.(NOT GOOD ENOUGH!)

DENVER — In patients with ischemic stroke, treatment with endovascular therapy with medical care led to better functional outcomes at 1 year compared with medical care alone. according to a speaker.

“In 2023, we had several trials that were groundbreaking in our field, that showed significant benefit for endovascular therapy for patients who present with large core ischemic stroke,” Amanda Opaskar, MD, a vascular neurologist and assistant professor of neurology at Case Western Reserve University, said during her presentation at the American Academy of Neurology annual meeting.

Ischemic Stroke
Recent research has determined benefits of endovascular therapy for ischemic stroke outcomes at 1 year. Image: Adobe Stock

“The question was how do these patients recover over that longer term, first year.”

Opaskar and colleagues sought to evaluate safety and efficacy of endovascular therapy (EVT) for ischemic stroke in the SELECT2 trial using clinical outcomes at 1-year follow-up. SELECT2 was a phase 3, international, multicenter, prospective, randomized, open-label trial with blinded endpoint assessment.

It included 352 individuals diagnosed with a large ischemic core on non-contrast CT (ASPECTS 3-5) scan, perfusion or MRI who received either EVT and best medical management (n = 178; median age 66 years; 71% female) or best medical management only (n = 174; median age 67 years; 74% female).

The study’s primary outcome was modified Rankin Scale (mRS) score at 1-year follow-up, evaluated using generalized odds ratio (GOR), with secondary outcomes including functional independence (0 to 2 mRS score), independent ambulation (mRS 0 to 3) and quality of life scores at 1-year follow-up.

A total of 93% (329 of 352) of enrollees completed the follow-up, with 23% of those who received EVT recording an mRS score of 0 to 2 compared with 8% of those who received medical care only.

Thrombectomy significantly improved the 1-year mRS score distribution (WMW probability of superiority = 0.59; 95% CI, 0.53-0.64; GOR = 1.43; 95% CI, 1.14-1.78), functional independence (EVT: 24% vs MM: 6%, RR = 3.17; 95% CI, 1.73-5.79) and independent ambulation (EVT: 37% vs MM: 18%, RR =1.85; 95% CI, 1.3-2.63) compared with medical care alone.

Data additionally showed EVT led to better QoL scores in functional independence, mobility, ambulation, sociability, cognition and depression compared with medical care alone.

“It is important to note we think about the potential recovery of these patients both in clinical trial design as well as when we are counseling (them),”(I'm sure you're counseling them to accept less than 100% recovery! I hope like hell they are screaming about your incompetence!)  Opaskar said. “That their recovery extends not just in 3 months, but it goes longer, up to a full year.”(But what the hell are you doing to get them to 100% recovery? NOTHING?)

Sources/Disclosures

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Source:

Opaskar A, et al. Long-term outcomes and EVT treatment effect from randomized controlled trial of endovascular thrombectomy for large ischemic strokes (SELECT2). Presented at: American Academy of Neurology annual meeting; April 13-18, 2024; Denver.

Disclosures: Opaskar reports no relevant financial disclosures.

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