Tuesday, April 24, 2012

New device removes stroke-causing blood clots better than standard treatment


New device removes stroke-causing blood clots better than standard treatment
Date: 02/03/2012
Contact: Amy Albin 
An experimental device for removing blood clots in stroke patients dramatically outperformed the standard mechanical treatment, according to research presented by UCLA Stroke Center director Dr. Jeffrey L. Saver at the American Stroke Association's 2012 international conference in New Orleans on Feb. 3.
The SOLITAIRE Flow Restoration Device is among an entirely new generation of devices designed to remove blood clots from blocked brain arteries in patients experiencing stroke. It has a self-expanding, stent-like design and, once inserted into a clot using a thin catheter tube, it compresses and traps the clot. The clot is then removed by withdrawing the device, thus reopening the blocked blood vessel.
In the first U.S. clinical trial of SOLITAIRE, the device opened blocked vessels without causing symptomatic bleeding in or around the brain in 61 percent of patients. The standard Food and Drug Administration–approved mechanical device — a corkscrew-type clot remover called the MERCI Retriever — was effective in 24 percent of cases.
The use of the new device also led to better survival three months after a stroke. There was a 17.2 percent mortality rate with the new device, compared with a 38.2 percent rate with the older one.
"This new device heralds a new era in acute stroke care," said Saver, the study's lead author and a professor of neurology at the David Geffen School of Medicine at UCLA. "We are going from our first generation of clot-removing procedures, which were only moderately good in reopening target arteries, to now having a highly effective tool. This really is a game-changing result."
About 87 percent of all strokes are caused by blood clots blocking a blood vessel supplying the brain. The stroke treatment that has received the most study is the FDA–approved clot-busting drug known as tissue plasminogen activator, but this drug must be given within four-and-a-half hours after the onset of stroke symptoms, and even more quickly in older patients.
When clot-busting drugs cannot be used or are ineffective, the clot can sometimes be mechanically removed during, or beyond, the four-and-a-half–hour window. The current study, however, did not compare mechanical clot removal to drug treatment. 
For the trial, called SOLITAIRE With the Intention for Thrombectomy (SWIFT), researchers randomly assigned 113 stroke patients at 18 hospitals to receive either SOLITAIRE or MERCI therapy within eight hours of stroke onset, between January 2010 and February 2011. The patients' average age was 67, and 68 percent were male. The time from the beginning of stroke symptoms to the start of the clot-retriever treatment averaged 5.1 hours. Forty percent of the patients had not improved with standard clot-busting medication prior to the study, while the remainder had not received it. 
At the suggestion of a safety monitoring committee, the trial was ended nearly a year earlier than planned due to significantly better outcomes with the experimental device.
Other statistically significant findings included:
  • 2 percent of SOLITAIRE-treated patients had symptoms of bleeding in the brain, compared with 11 percent of MERCI patients.
  • At the 90-day follow-up, overall adverse event rates, including bleeding in the brain, were similar for the two devices.
  • 58 percent of SOLITAIRE-treated patients had good mental/motor functioning at 90 days, compared with 33 percent of MERCI patients.
  • The SOLITARE device also opened more vessels when used as the first treatment approach, necessitating fewer subsequent attempts with other devices or drugs.
"Nearly a decade ago, our UCLA Stroke Center team invented the first stroke retrieval device — the MERCI Retriever — and now we are pleased to have helped develop and successfully test a superior, next-generation clot removing device," said Dr. Reza Jahan, associate professor of radiology at UCLA and the study's principal neurointerventional investigator, who also led the pre-clinical studies. "It is exciting to have a highly effective new tool that can improve the outcomes for more stroke patients."
Additional co-authors included Dr. Elad Levy, Dr. Tudor G. Jovin, Dr. Blaise Baxter, Dr. Raul Nogueira, Dr. Wayne Clark, Dr. Ronald Budzik, Dr. Osama O. Zaidat and the SWIFT trial investigators.
Saver and Jahan received compensation from Covidien as scientific consultants for the design and conduct of the trial.
Covidien, the device manufacturer, funded the study. Although not yet approved in the United States, SOLITAIRE is used in Europe.
The UCLA Stroke Center, recognized as one of the world's leading centers for the management of cerebral vascular disease, treats simple and complex vascular disorders by incorporating recent developments in emergency medicine, stroke neurology, microneurosurgery, interventional neuroradiology, stereotactic radiology, neurointensive care, neuroanesthesiology and rehabilitation neurology. The program is unique in its ability to integrate clinical and research activities across multiple disciplines and departments. Founded in 1994, the UCLA Stroke Center is designated as a certified Primary Stroke Center by the national Joint Commission on Accreditation of Healthcare Organizations.
For more news, visit the UCLA Newsroom and follow us on Twitter

Saturday, April 14, 2012

IF YOU CAN'T ACCEPT ME OR JUST DON'T LIKE ME......DON'T PRETEND YOU DO!!

you know who you are...and now so do i. i do not need FAKE  friends who blow smoke up my ass one minute and then ignore me for THE COOL CROWD the next. all i had to do was compare your time lines. i don't know what kind of SHITS and GRINS you gained from this,but I DO NOT DESERVE TO BE TREATED THAT WAY! NO ONE DOES! ~PRETENDING TO BE LAUGHING WITH ME WHEN OBVIOUSLY YOU WERE JUST LAUGHING AT ME THE WHOLE TIME. 


HATE TO TELL YOU THIS GIRLS BUT YOU ARE THE FOOLS,NOT ME!! BEING DISABLED IS NOT A LIFE CHOICE,BEING CRUEL IS!
i did chose NOT to block you,but to unfollow you! and yes i unfollowed many people who you follow  or who follow you.it will be up to them as to whether or not they continue to follow me and if they chose to interact with me.i do however ask that they only do so with honest intentions!
 i do realize some of them are your collateral damage and have done nothing wrong. however,i need all to  know i am not here to be popular,i am not here because i am starving for attention,affection,pitty or sympathy! 


i am here to socialize with positive people who accept themselves and others,who respect themselves and others,who are honest,caring,giving and appreciative of the same in others. 
i am here to raise awareness of #MOYAMOYADISEASE and to support and acknowledge many other causes as well. i am here to enjoy many of my personal INTERESTS i have had longer than my disabilities.
also, to interact at times with those who have achieved fame in varied forms,with talent,hard work and dedication. i would much rather share a joke,a smile,or a moment of shared interest with them,than to ever buy a tabloid filled with the same senseless, ignorant fodder i was faced with  last night.


i'm not saying i am perfect and never make a mistake or a bad choice,i'm being honest enough with myself and with you to say,I AM NOT PERFECT,I AM FLAWED AND THO I MAY SAY THE WRONG THING OR LAUGH AT THE WRONG TIME ,IT IS NEVER MY INTENTION TO INSULT OR MISTREAT ANYONE!!! AND I WOULD APPRECIATE THE SAME IN RETURN...

Wednesday, April 4, 2012

NEW REPORT FROM THE THE NATIONAL STOKE ASSOCIATION


  Moyamoya characteristics in the USA defined
By Eleanor McDermid
30 March 2012
Neurosurgery 2012; Advance online publication
MedWire News: The diagnosis of moyamoya disorder and associated ischemic stroke has increased over recent years in the USA, say researchers who characterized a large cohort of patients.
Using the US Nationwide Inpatient Sample, Robert Starke (University of Virginia, Charlottesville, USA) and colleagues identified 2280 patients with moyamoya disorder admitted to hospital during 2002-2008. This equated to a national annual admission rate of about 0.57 per 100,000 people.
The number of admissions for moyamoya disorder roughly doubled between 2002 and 2008. "This may be due to an increased incidence of the disease or increased awareness of the disease, improved imaging modalities, and an increase in the incidence of the diagnosis of moyamoya phenomena as the etiology behind strokes," the researchers write in Neurosurgery.
Ischemic stroke was more common than hemorrhagic stroke in adults (18.8 vs 11.0%) and children (16.4 vs 3.3%). The overall proportion of patients with diagnosed with ischemic stroke rose significantly over the study period, from less than 15% to more than 20%, whereas diagnosis of hemorrhagic stroke remained stable over time.
There were more women than men in the cohort, at 72% versus 28%, and the mean and median age at presentation was 32 years. This unimodal pattern remained when Starke et al divided the patients into Asian and non-Asian races. They note that the established pattern in Asian populations is of two peaks of presentation: the first during childhood and the second in adulthood.
The team adds that moyamoya was previously thought to affect primarily Asians, yet White people accounted for 49% of the current cohort, with Black people accounting for 24%, and Asian and Hispanic races for 11% each. This reflects US demographics, rather than being weighted towards Asians, say Starke et al.
Use of extracranial-to-intracranial bypass increased over the study period, especially among patients with ischemic stroke, yet in-hospital mortality after bypass was low. However, the team says that there "may be a reluctance to operate on more fragile patients" and that surgeons may wait for patients with acute symptoms to stabilize before operating, accounting for the low mortality rate.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012