Sunday, April 10, 2022

In Stroke, When Is a Good Outcome Good Enough?

Very simple, when your survivor declares it good enough without your intervention of trying to force your fucking tyranny of low expectations on your patients.

In Stroke, When Is a Good Outcome Good Enough?

  • Lee H. Schwamm, M.D.

In this issue of the Journal, Yoshimura and colleagues1 report the favorable results of a well-conducted randomized trial comparing mechanical thrombectomy (endovascular therapy) with medical care in patients with large-vessel occlusion and large cerebral infarctions. Previous trials of endovascular therapy in selected populations of patients with small and medium-sized strokes have shown beneficial treatment effects, thereby setting the stage for randomized trials of endovascular therapy in patients with large infarctions.2 Neurologists have been reluctant to perform endovascular therapy in patients with large infarctions because of the putative risk of bleeding into the infarction and the likelihood that outcomes would be . . .

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Disclosure forms provided by the author are available with the full text of this editorial at NEJM.org.

Author Affiliations

From the Stroke Service, Massachusetts General Hospital, and Harvard Medical School, Boston.

 

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