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.

Showing posts with label Balloon-guided catheter. Show all posts
Showing posts with label Balloon-guided catheter. Show all posts

Thursday, February 21, 2019

Balloon-guided catheter surgery provides better outcomes for stroke patients

Wow, Using the tyranny of low expectations in trying to justify that 'better' is good enough. 100% recovery is the goal of all survivors. NOT restoring blood flow.  The goals of the doctors and the patients need to align with survivors goals taking precedence.

Balloon-guided catheter surgery provides better outcomes for stroke patients

Patients who have experienced a stroke as a result of blockages of the arteries in the brain have better outcomes with the use of balloon-guided catheter surgery as compared to having a conventional guided catheter procedure.
Clot retrieval is typically the treatment for large vessel occlusions (LVO), which are strokes that result from a blockage in one of the major arteries of the brain. Treatment options include use of a balloon-guided catheter or a conventional guided catheter.
Researchers from Boston University School of Medicine (BUSM), Mercy Health Neuroscience Institute of Toledo, University of Toledo and several other centers compared two groups of patients. In one group, patients experienced a LVO stroke and underwent treatment with a stent retriever (device used to unclog blood clots) with a balloon-guided catheter. During clot retrieval, the balloon on the guide catheter was temporarily inflated in the carotid artery to stop blood flow as the clot was being removed. In the second group, patients had a LVO stroke and underwent treatment with a stent retriever using a conventional guide catheter.
"When we compared both groups, patients who had balloon-guided catheter had better restoration of blood flow scores and better clinical outcomes," explained corresponding author Thanh Nguyen, MD, associate professor of neurology at BUSM and director, Interventional Neuroradiology and Interventional Neurology at Boston Medical Center (BMC).
"Achieving complete or near complete blood flow is the goal to restore strength, language, coordination, reflexes and sensation to patients suffering from ischemic stroke," said senior author Osama Zaidat, MD, who established the TRevo Acute Ischemic Stroke Thrombectomy (TRACK) Registry.
"Stopping arterial flow is an important step that can improve restoration of blood flow, reduce the number of blood clot emboli to a new area and potentially improve clinical outcome," added co-author Mohamad Abdalkader, MD, assistant professor of radiology at BUSM and interventional neuroradiologist at BMC.
"Our study adds to the growing body of evidence that highlights the potential of balloon-guide catheters to improve stroke patient outcomes. Future studies are necessary to fully understand the role of this technology in a larger patient population," said co-author Alicia Castonguay, PhD, assistant professor in the College of Medicine and Life Sciences at The University of Toledo.
This study builds on Nguyen, Zaidat and Castonguay's prior seminal publication from the multicenter national North American Solitaire Acute Stroke (NASA) Registry demonstrating positive effect of balloon guide catheters in improving reperfusion and clinical outcome in patients with large vessel occlusion stroke published in the journal Stroke in 2014.
These findings appear in the Journal of NeuroInterventional Surgery.

Monday, February 4, 2019

Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy

Wrong endpoints measured. Survivors don't give a shit about; 

  1. groin puncture time

  2. reperfusion time

  3. first pass effect

  4. number of passes 

  5. Didn't even measure how close to 100% recovery survivors got. 

Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy

  1. Thanh N Nguyen1,2,3,
  2. Alicia C Castonguay4,
  3. Raul G Nogueira5,
  4. Diogo C Haussen5,
  5. Joey D English6,
  6. Sudhakar R Satti7,
  7. Jennifer Chen8,
  8. Hamed Farid9,
  9. Candace Borders10,
  10. Erol Veznedaroglu11,
  11. Mandy J Binning11,
  12. Ajit S Puri12,
  13. Nirav A Vora13,
  14. Ron F Budzik13,
  15. Guilherme Dabus14,
  16. Italo Linfante14,
  17. Vallabh Janardhan15,
  18. Amer Alshekhlee16,
  19. Michael G Abraham17,
  20. Randall C Edgell18,
  21. M Asif Taqi19,
  22. Ramy El Khoury20,
  23. Maxim Mokin21,
  24. Aniel Q Majjhoo22,
  25. Mouhammed R Kabbani23,
  26. Michael T Froehler24,
  27. Ira Finch25,
  28. Sameer A Ansari26,
  29. Roberta Novakovic27,
  30. Mohamad Abdalkader1,2,3,
  31. Osama O Zaidat28

Author affiliations


Abstract

Introduction The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter.
Methods The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician.
Results 536 anterior circulation patients (of whom 279 (52.1%) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4±15.3 vs 68.1±13.6, P=0.03) and lower rate of hypertension (72% vs 79%, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84% vs 75.5%, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome(What the fuck is your definition of this? Mine is 100% recovery.) at 3 months was superior in patients with BGC (57% vs 40%; P=0.0004) with a lower mortality rate (13% vs 23%, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95% CI 1.3 to 3.1, P=0.001).
Conclusions In acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.