Somatosensory Evoked Potential Monitoring for Stroke Treatment Outcomes
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Solution Overview
Problem
Current methods for selecting patients for endovascular treatment in acute ischemic stroke are inadequate, leading to variable outcomes and a high likelihood of significant disability or death, despite advances in clinical and neuroimaging criteria.
Innovation Solution
Monitoring somatosensory evoked potentials (SEPs) before and during endovascular treatment to predict the outcome, using SEP amplitude ratios ipsilateral and contralateral to the stroke site to identify patients likely to benefit from endovascular therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If endovascular treatment is performed based on current clinical and neuroimaging criteria, then arterial recanalization is achieved, but clinical and functional recovery remains suboptimal with high disability or death rates
Solution Approach 1:
The patent replaces complex clinical and neuroimaging evaluation systems with a simple electrophysiological monitoring system (SEP). Instead of using multiple clinical variables and imaging parameters, the invention uses somatosensory evoked potentials to directly assess cortical function and predict treatment outcome, substituting a straightforward electrophysiological measurement for complex multi-parameter assessment.
Solution Approach 2:
The patent changes the fundamental parameter used for patient selection from anatomical/imaging parameters (vessel occlusion, infarct core, penumbra) to functional electrophysiological parameters (SEP presence, amplitude, latency). This parameter transformation enables direct assessment of cortical viability and predictive value for functional recovery, improving selection accuracy.
2Loss of information
If comprehensive clinical and neuroimaging evaluation is used for patient selection, then more information is gathered, but the likelihood of significant disability or death remains between 40 and 67%
Solution Approach 1:
The patent substitutes comprehensive but insufficient clinical and neuroimaging evaluation with targeted electrophysiological monitoring. SEP provides direct functional information about cortical integrity and thalamocortical pathway viability, replacing indirect anatomical inference with direct functional measurement, thereby improving prognostic accuracy.
Solution Approach 2:
The patent implements real-time feedback through SEP monitoring during endovascular treatment. By continuously assessing SEP changes in response to recanalization, the system provides immediate feedback on cortical reperfusion and functional recovery potential, enabling dynamic adjustment of treatment strategy and improving outcome prediction.
Data Source
Figure 1A~1C
AI summary
The present application provides for use of a somatosensory evoked potential (SEP) during the hyperacute stroke phase as marker for predicting the outcome of endovascular treatment in a patient suffering from acute ischemic stroke, wherein when the SEP ipsilateral to the stroke site has an amplitude from 60% to 100% with respect to the corresponding SEP contralateral to the stroke site this is indicative of good outcome of the endovascular treatment, whereas when the SEP ipsilateral to the stroke site has an amplitude from 0% to 20% with respect to the corresponding SEP contralateral to the stroke site this is indicative of bad outcome of the endovascular treatment.