Coda Change Stroke Management in 2022: Part 1
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Feb 2, 2022 Fahad Ashraf, a stroke fellow in neurology at Sir Charles Gairdner Hospital, shares insights on innovative advancements in stroke care. He highlights the evolution of mechanical thrombectomy, emphasizing improved techniques and outcomes. The discussion covers the importance of public awareness, FAST screening, and coordinated response in stroke management. Fahad also navigates the complexities of treatment decisions, including when to opt for thrombectomy versus conservative care, focusing on patient quality of life and clinical factors.
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Thrombectomy's Transformative Evidence
- Mechanical thrombectomy proved clear functional benefit in landmark trials and transformed acute stroke care over the past decade.
- Advanced imaging now helps identify who benefits, shifting decision-making from time-only to tissue-based assessment.
Devices Let Us Reach Further Clots
- Improvements in devices and technique have expanded safe thrombectomy to more distal vessels and varied scenarios.
- These advances increase recanalization rates and improve patient outcomes beyond the original trials.
Local Outcomes Match Landmark Trials
- Sir Charles Gairdner Hospital followed thrombectomy outcomes with 330 cases in 2020 and 311 in 2021 using three-month mRS follow-up.
- They achieved ~65–70% functional independence, matching or exceeding landmark trial results.