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4 Comments on "Episode 11 – Ischemic Stroke 2013"

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david barounis
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Scott,

With the stroke guidelines published prior to the release of MR RESCUE, IMS III AND SYNTHESIS expansion investigators all showing no benefit to IA tPA +/- thrombectomy over IV tPA do you think this will change the utility of the CTA in acute ischemic stroke? I used to get CTA’s to evaluate for possible thrombectomy in patients with large cortical lesions, but now I’m less convinced (assuming we weren’t looking for a dissection). Are you going to cover these studies in any future podcasts, as I think many big academic shops had been using IA lysis +/- thrombectomy to “increase revascularization rates” but it seems increasing flow hasn’t correlated with functional scores at 90 days.

Thanks as always for the stellar stuff.

-Dave

http://www.nejm.org/doi/full/10.1056/NEJMoa1213701

http://www.nejm.org/doi/full/10.1056/NEJMoa1212793

http://www.nejm.org/doi/full/10.1056/NEJMoa1214300

emcrit
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Only if someone writes a guideline on it.

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[…] the lack of ecass III suggested criteria for not thrombolysing in the3-4.5 slot ! Acep document here ………at least soon and hopefully Scott’s […]

Salim R. Rezaie, MD
Guest

Hey Scott,
Just FYI, you ACEP link is not working for the ACEP 2013 Guidelines. I have attached here in case anyone needs it. Thanks for the great podcast series.

Salim

http://www.aan.com/practice/guideline/uploads/584.pdf

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