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 810: Tooth Replantation

Podcast 810: Tooth Replantation

Contributor: Jarod Scott, MD Educational Pearls: There is a 1-hour window for tooth replantation in ED Cold milk is often best transport media unless there is access to specialized solutions (Hank's ...

5 Syys 20224min

Podcast 809: Achilles Tendon Rupture

Podcast 809: Achilles Tendon Rupture

Contributor: Aaron Lessen, MD Educational Pearls: Achilles tendon rupture usually presents in younger, healthy patients after a sports injury Patients typically present complaining of an abrupt onset...

30 Elo 20224min

Podcast 808: BVM and PEEP Valve

Podcast 808: BVM and PEEP Valve

Contributor: Dylan Luyten, MD Educational Pearls: Positive End Expiratory Pressure (PEEP) is positive pressure within the lungs and maintained throughout the entire respiratory cycle. It is the press...

29 Elo 20224min

Podcast 807: Ring Removal Tricks

Podcast 807: Ring Removal Tricks

Contributor: Jared Scott, MD Educational Pearls: If a patient is in significant pain, a digital block can be helpful. Pain management alone may allow for manual ring removal.  Ring cutters and trauma...

23 Elo 20224min

Podcast 806: Normal ECGs

Podcast 806: Normal ECGs

Contributor: Jared Scott, MD Educational Pearls: Physicians are typically advised not to trust computer interpretation of ECGs Retrospective study was done of computer interpreted normal ECGs to eva...

22 Elo 20223min

Podcast 805: Tunneled Peritoneal Catheter

Podcast 805: Tunneled Peritoneal Catheter

Contributor: Aaron Lessen, MD Educational Pearls: Patients with recurrent ascites may need frequent outpatient or emergency department paracentesis which can be time consuming and uncomfortable for p...

16 Elo 20223min

Podcast 804: Brugada Criteria for V Tach

Podcast 804: Brugada Criteria for V Tach

Contributor: Peter Bakes, MD Educational Pearls: Tachycardia describes a heart rate of >120 beats per minute Wide Complex describes a QRS duration of >120 ms or 3 small boxes on a standard EKG The ma...

9 Elo 20226min

Podcast 803:  Sedation During Intubation

Podcast 803: Sedation During Intubation

Contributor: Aaron Lessen, MD Educational Pearls: Awareness with recall of paralysis can occur in intubated and ventilated patients receiving paralytic medications  Patients who suffer from this eff...

8 Elo 20223min

Suosittua kategoriassa Tiede

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