Six Months Later: Final Helistroke Pilot Time Analysis
The 2015 trials for interventional management of stroke yielded high rates of recanalization and good functional outcome. The DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-up and Late Presenting Strokes Undergoing Neurointervention with Trevo; NCT02142283) and DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3; NCT02586415) trials (1,2) demonstrated effectiveness for up to 24 hours (2). The workflow analysis of the SWIFT-PRIME (Solitaire with the Intention for Thrombectomy as PRIMary Endovascular Treatment; NCT01657461) trial data showed that there was a 91% probability of favorable outcome (defined as a modified Rankin scale of 0 –2) if patients were recanalized within 150 minutes of onset (3).
AbstractObjectiveTo evaluate the efficacy and safety of endovascular treatment (ET) of acute ischemic stroke (AIS) caused by intracranial atherosclerotic large vessel occlusion (ICAS-LVO).MethodsA systemic review and meta-analysis were conducted on studies published between July 2005 and October 2018 on the outcomes of ET in patients with AIS due to ICAS-LVO. The outcomes of the ICAS-LVO and embolic LVO groups were also compared.ResultsA total of 17 studies including 1315 subjects with ICAS-LVO were included. In the single-arm meta-analysis, the pooled estimates of successful recanalization rate, favorable outcomes, ...
Conclusions: Our results support the prescription of rt-PA in AIS patients 3–4.5 h after onset as an effective and tolerable treatment in their functional recovery.
PMID: 31610557 [PubMed - in process]
This cohort study examines the use of endovascular recanalization in pediatric patients with arterial ischemic stroke and clinical outcomes.
The standard of care for stroke treatment in adults changed rapidly in 2015 after results from 5 major clinical trials each showed efficacy of endovascular treatment of anterior circulation large-vessel occlusion within 6 hours of stroke onset. The positive results of these studies have since raised questions about whether endovascular therapy should be used for children who present with stroke due to large-vessel occlusion and, other than age, fit adult criteria for thrombectomy. Compared with the occurrence in adults, ischemic stroke in children is uncommon, but remains important to address because the resulting disabili...
Before the advent of fibrinolytic therapy as a gold standard method of care for cases of acute ischemic stroke in Romania, issues regarding legal medicine aspects involved in this area of medical expertise wer...
In their systematic review and meta-analysis (n=5 studies; 16,712 patients), Giannopoulos et al.1 compared synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) vs. staged carotid artery stenting (CAS) followed by CABG. They demonstrated that perioperative stroke (3% [447/15,727] vs. 3% [33/985], for CEA/CABG vs. CAS/CABG, respectively; odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.43-1.64; I2=39.1%) and transient ischemic attack (TIA) rates (1% [2/193] vs 4% [4/95] for CEA/CABG vs.
ConclusionWe have constructed a stereotaxic template set of macaque brain named HJT, which standardizes macaque neuroimaging data analysis, supports novel radiotracer development and facilitates translational neuro-disorders research.