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.

Friday, January 7, 2022

Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy

Once again, the wrong definition of success; reperfusion.

You're not measuring 100% recovery which means  it's not important enough for you to solve. Maybe, just maybe you want to talk to your patients because you're forcing your tyranny of low expectations on them.  Survivors don't fucking care about reperfusion, that's just the first step to 100% recovery. 

Business 101: If you don't measure it, it is not important, so obviously 100% recovery is not important. 

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

The latest here:

Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy

Results from the ESCAPE-NA1 Trial

Abstract

Background

Successful reperfusion determines the treatment effect of endovascular thrombectomy. We evaluated stent-retriever characteristics and their relation to reperfusion in the ESCAPE-NA1 trial.

Methods

Independent re-scoring of reperfusion grade for each attempt was conducted. The following characteristics were evaluated: stent-retriever length and diameter, thrombus position within stent-retriever, bypass effect, deployment in the superior or inferior MCA trunk, use of balloon guide catheter and distal access catheter. Primary outcome was successful reperfusion defined as expanded thrombolysis in cerebral infarction (eTICI) 2b–3 per attempt. The secondary outcome was successful reperfusion eTICI 2b–3 after the first attempt. Separate regression models for each stent-retriever characteristic and an exploratory multivariable modeling to test the impact of all characteristics on successful reperfusion were built.

Results

Of 1105 patients in the trial, 809 with the stent-retriever use (1241 attempts) were included in the primary analysis. The stent-retriever was used as the first-line approach in 751 attempts. A successful attempt was associated with thrombus position within the proximal or middle third of the stent (OR 2.06; 95% CI: 1.24–3.40 and OR 1.92; 95% CI: 1.16–3.15 compared to the distal third respectively) and with bypass effect (OR 1.7; 95% CI: 1.07–2.72). Thrombus position within the proximal or middle third (OR 2.80; 95% CI: 1.47–5.35 and OR 2.05; 95% CI: 1.09–3.84, respectively) was associated with first-pass eTICI 2b–3 reperfusion. In the exploratory analysis accounting for all characteristics, bypass effect was the only independent predictor of eTICI 2b–3 reperfusion (OR 1.95; 95% CI: 1.10–3.46).

Conclusion

The presence of bypass effect and thrombus positioning within the proximal and middle third of the stent-retriever were strongly associated with successful reperfusion.

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