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.

Thursday, May 9, 2024

Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size

But you're missing the gorilla crossing the room, you don't tell us how many of those surviving patients got 100% recovered; the only goal in stroke! Leaving them disabled post stroke is NOT GOOD ENOUGH! You'll want full recovery when you are the 1 in 4 per WHO that has a stroke Perhaps you might want to start researching those solutions now, while you still can.

 

Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size

Authors: Vincent Costalat, M.D., Ph.D., Tudor G. Jovin, M.D. https://orcid.org/0000-0002-2619-6975, J.F. Albucher, M.D., Christophe Cognard, M.D., Ph.D., Hilde Henon, M.D., Nasreddine Nouri, M.D., Benjamin Gory, M.D., Ph.D., for the LASTE Trial Investigators*Author Info & Affiliations
Published May 8, 2024
N Engl J Med 2024;390:1677-1689
DOI: 10.1056/NEJMoa2314063

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  • Abstract

    Background

    The use of thrombectomy in patients with acute stroke and a large infarct of unrestricted size has not been well studied.

    Methods

    We assigned, in a 1:1 ratio, patients with proximal cerebral vessel occlusion in the anterior circulation and a large infarct (as defined by an Alberta Stroke Program Early Computed Tomographic Score of ≤5; values range from 0 to 10) detected on magnetic resonance imaging or computed tomography within 6.5 hours after symptom onset to undergo endovascular thrombectomy and receive medical care (thrombectomy group) or to receive medical care alone (control group). The primary outcome was the score on the modified Rankin scale at 90 days (scores range from 0 to 6, with higher scores indicating greater disability). The primary safety outcome was death from any cause at 90 days, and an ancillary safety outcome was symptomatic intracerebral hemorrhage.
    Download a PDF of the Plain Language Summary.

    Results

    A total of 333 patients were assigned to either the thrombectomy group (166 patients) or the control group (167 patients); 9 were excluded from the analysis because of consent withdrawal or legal reasons. The trial was stopped early because results of similar trials favored thrombectomy. Approximately 35% of the patients received thrombolysis therapy. The median modified Rankin scale score at 90 days was 4 in the thrombectomy group and 6 in the control group(What are your EXACT SOLUTIONS to get them to 100% recovery? Don't have any? Then get the hell out of stroke!) (generalized odds ratio, 1.63; 95% confidence interval [CI], 1.29 to 2.06; P<0.001). Death from any cause at 90 days occurred in 36.1% of the patients in the thrombectomy group and in 55.5% of those in the control group (adjusted relative risk, 0.65; 95% CI, 0.50 to 0.84), and the percentage of patients with symptomatic intracerebral hemorrhage was 9.6% and 5.7%, respectively (adjusted relative risk, 1.73; 95% CI, 0.78 to 4.68). Eleven procedure-related complications occurred in the thrombectomy group.

     

    Conclusions

    In patients with acute stroke and a large infarct of unrestricted size, thrombectomy plus medical care resulted in better functional outcomes and lower mortality than medical care alone but led to a higher incidence of symptomatic intracerebral hemorrhage. (Funded by Montpellier University Hospital; LASTE ClinicalTrials.gov number, NCT03811769.)

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