Podcast 688: tPA Before Thrombectomy

Podcast 688: tPA Before Thrombectomy

Contributor: Aaron Lessen, MD

Educational Pearls:

  • DEVT Trial, a recent non-inferiority study, looked at giving tPA prior to endovascular thrombectomy and was stopped early because there was no benefit shown to giving tPA before this intervention
  • Coupled with the SKIP and DIRECT MT trials corroborating these findings, it appears that giving tPA prior to thrombectomy is not indicated
  • Whether patients should receive tPA prior to transfer for thrombectomy (i.e. they are in a rural healthcare setting) is still unclear

References

Yang P, Treurniet KM, Zhang L, et al. Direct Intra-arterial thrombectomy in order to Revascularize AIS patients with large vessel occlusion Efficiently in Chinese Tertiary hospitals: A Multicenter randomized clinical Trial (DIRECT-MT)-Protocol. Int J Stroke. 2020;15(6):689-698. doi:10.1177/1747493019882837

Suzuki K, Matsumaru Y, Takeuchi M, et al. Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial [published correction appears in JAMA. 2021 May 4;325(17):1795]. JAMA. 2021;325(3):244-253. doi:10.1001/jama.2020.23522

Zi W, Qiu Z, Li F, et al. Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients With Acute Ischemic Stroke: The DEVT Randomized Clinical Trial. JAMA. 2021;325(3):234-243. doi:10.1001/jama.2020.23523

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1145)

Podcast 883: Migraine Treatment in Cardiovascular Disease

Podcast 883: Migraine Treatment in Cardiovascular Disease

Contributor: Jorge Chalit, OMS II Educational Pearls: Migraine pathophysiology Primarily mediated through the trigeminovascular system Serotonin, dopamine, and calcitonin gene-related peptide (...

25 Joulu 20233min

Podcast 882: Thrombolytics for Minor Strokes

Podcast 882: Thrombolytics for Minor Strokes

Contributor: Aaron Lessen MD Educational Pearls: How is the severity of a stroke assessed? Strokes are assessed by the NIH Stroke Scale (NIHSS), this scale has different tasks, such as asking the pe...

20 Joulu 20232min

Podcast 881: Pediatric Readmissions

Podcast 881: Pediatric Readmissions

Contributor: Nick Tsipis MD Educational Pearls: The review article assessed 16.3 million patients across six states to identify those at high-risk for critical revisit Criteria for critical revis...

12 Joulu 20233min

Podcast 880: OB Delivery in the ED

Podcast 880: OB Delivery in the ED

Contributor: Meghan Hurley MD Educational Pearls: Pearls about labor: Labor is split into 3 stages. Stage 1 starts when the first persistent contractions are felt and goes up until the cervix is ...

4 Joulu 20238min

Podcast 879: A Case of Pediatric Anaphylactic Shock

Podcast 879: A Case of Pediatric Anaphylactic Shock

Contributor: Dr. Taylor Lynch Educational Pearls: Time of arrival until intubation was 26 minutes but nobody tried anterior neck access like a cricothyrotomy until his dad arrived Traditional ACLS...

27 Marras 20235min

Podcast 878: Opioids for Low Back and Neck Pain

Podcast 878: Opioids for Low Back and Neck Pain

Contributor: Jared Scott MD Educational Pearls: Should we use opioids to treat low back and neck pain? The OPAL Trial, published in The Lancet, in June 2023, attempted to answer this very question. ...

20 Marras 20233min

Podcast 877: Viral Respiratory Infections in Children

Podcast 877: Viral Respiratory Infections in Children

Contributor: Jared Scott MD Educational Pearls A recently published study assessed the burden of respiratory viruses in a longitudinal cohort of children from 0 to 2 years of age The children in t...

13 Marras 20233min

Podcast 876: Sedation Pearls

Podcast 876: Sedation Pearls

Contributor: Travis Barlock MD Educational Pearls: Common sedatives used in the Emergency Department and a few pearls for each. Propofol Type: Non-barbiturate sedative hypnotic agonizing GABA rec...

6 Marras 20235min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-sosiopodi
ihanat-ipanat
mielipaivakirja
rss-bios-podcast
rss-duodecim-lehti
rss-laakaripodi
rss-radplus
rss-opeklubi
rss-lihavuudesta-podcast