Tuesday, January 26, 2016

VIDEO: Endovascular therapy key approach to improve time to treatment in acute ischemic stroke

Actually you are wrong, you have no idea of the correct approach to this. The key approach to improve time to treatment is to solve the diagnosis problem. Make it objective and remove the scans and neurologist from the equation. Many possibilities if you are following research at all.
This is easy to solve; you fund researchers to test out these 17 possibilities to find out which one is the best. Or maybe the Qualcomm Xprize for the tricorder. No installing scanners in the ambulance, that is a waste of money. The goal should be to deliver tPA fast enough to prevent the neuronal cascade of death. But first you'll need research to determine how fast that needs to be.
 None of this lazy door-to-needle time, in the ambulance for tPA should be the goal.
http://www.healio.com/cardiology/stroke/news/online/%7B7940c895-c29f-4e8a-b183-ac57f5d3f954%7D/video-endovascular-therapy-key-approach-to-improve-time-to-treatment-in-acute-ischemic-stroke?utm_source=maestro&utm_medium=email&utm_campaign=cardiology%20news
Gregg Fonarow, MD, professor of cardiovascular medicine at UCLA, discusses the role of endovascular therapy in improving the treatment of patients with acute ischemic stroke, an area of focus at the American Heart Association Scientific Sessions 2015.
Highlighting onset-to-treatment time, Fonarow discusses the clinical outcomes observed with stent retrievers in context of the sole pharmacologic therapy, IV tissue plasminogen activator (tPA), shown to benefit this population.
“Time matters. Time is brain,” he said. “The time for the patient to get to the hospital and the time of arrival to beginning treatment … is critically important in limiting the size of stroke and improving functional recovery.”(Then solve the diagnosis problem)
Fonarow details “remarkable findings” from the AHA’s Target: Stroke Initiative as well as continued efforts to speed the process from arrival to diagnosis for patients receiving tPA and endovascular therapy.
Finally, he outlines the organized approach needed to achieve outcomes in practice with endovascular therapy including data collection, tracking and national goal-setting.  
“We’re beginning the work to capture the valuable data and assemble the teams that will be necessary working together to identify best practices,” Fonarow said. “The time to now speed our therapy for acute ischemic stroke is upon us.”

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