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4 Comments on "Episode 11 – Ischemic Stroke 2013"

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david barounis


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.



Only if someone writes a guideline on it.

Burning issues – we need to talk! | Long White Cloud EM

[…] 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

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.