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 760: Why Fentanyl is the Worst

Podcast 760: Why Fentanyl is the Worst

Contributor: Don Stader, MD Educational Pearls: Fentanyl's common administration route through pills has lowered the psychological barrier of using opioid compared to injecting and smoking heroin Fen...

1 Maalis 20228min

Podcast 759: Hyperkalemia and Myth of Kayexalate

Podcast 759: Hyperkalemia and Myth of Kayexalate

Contributor: Nick Tsipis, MD Educational Pearls: Acute hyperkalemia is characterized as serum K of 5.4 or higher in non-hemolyzed samples Hyperkalemia is commonly associated with end stage renal dise...

28 Helmi 20225min

Mental Health Monthly #10: The Elderly Psychotic Patient

Mental Health Monthly #10: The Elderly Psychotic Patient

Dr. Kim Nordstrom, a practicing emergency psychiatrist and associate professor with the University of Colorado, discusses various work-up models alongside valuable bedside tools for elderly patients w...

23 Helmi 202211min

Podcast 758: Vaccine Safety During Pregnancy

Podcast 758: Vaccine Safety During Pregnancy

Contributor: Nick Tsipis, MD Educational Pearls: Observational study in Israel evaluated cohort of vaccinated pregnant women receiving the initial Pfizer-BioNTech COVID-19 mRNA vaccine Looked at 24,...

22 Helmi 20223min

Podcast 757: History of Fevers and Thermometers

Podcast 757: History of Fevers and Thermometers

Contributor: Chris Holmes, MD Educational Pearls: Dr. Carl Reinhold August Wunderlich, of the mid-1800s, was the first physician to suggest temperature was related to disease processes and his measur...

21 Helmi 20226min

Podcast 756: Violence Towards ED Staff

Podcast 756: Violence Towards ED Staff

Contributor: Jared Scott, MD Educational Pearls: ACEP survey was done in 2018 looking at violence towards staff in the ED with only 10% of those solicited responding Survey found 47% of respondents w...

15 Helmi 20224min

Podcast 755: Tubo-Ovarian Abscess

Podcast 755: Tubo-Ovarian Abscess

Contributor: Peter Bakes, MD Educational Pearls: Tubo-ovarian abscess is a rare complication of pelvic inflammatory disease Usually presents with chief complaint of abdominal pain and is often diagno...

14 Helmi 20223min

Podcast 754: Balanced Fluids vs. Normal Saline, The Battle Continues

Podcast 754: Balanced Fluids vs. Normal Saline, The Battle Continues

Contributor: Aaron Lessen, MD Educational Pearls: Normal saline is thought to interfere with renal function and cause an acidosis and balanced fluids (like lactated ringers) are a better option The S...

8 Helmi 20223min

Suosittua kategoriassa Tiede

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