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 646: Thunderclap Headache, Think...RCVS?

Podcast 646: Thunderclap Headache, Think...RCVS?

Contributor: Aaron Lessen, MD Educational Pearls: When evaluating a thunderclap headache, don't forget RCVS! RCVS: reversible cerebral vasoconstriction syndrome Due to reversible spasms of cerebra...

8 Maalis 20213min

Podcast 645: Necrotizing Enterocolitis and More

Podcast 645: Necrotizing Enterocolitis and More

Contributor:  Peter Bakes, MD Educational Pearls: Necrotizing Enterocolitis (NEC) Presents in the first few days of life (often in the NICU) to 3 weeks old Risk factors include prematurity, excess ...

2 Maalis 20219min

Podcast 644: Covid Outcomes

Podcast 644: Covid Outcomes

Contributor: Aaron Lessen, MD Educational Pearls: Meta-analysis of 57,420 COVID+ patients evaluated mortality after intubation 45% mortality rate for all patients in the study 84.4% mortality in p...

1 Maalis 20213min

Podcast 643: Convulsions with Gastroenteritis

Podcast 643: Convulsions with Gastroenteritis

Contributor: Jared Scott, MD Educational Pearls: Differential Diagnosis: non-accidental trauma, febrile seizure, meningitis, hyponatremia, epilepsy Convulsions with gastroenteritis is a known entity...

23 Helmi 20215min

Podcast 642: Vasopressors

Podcast 642: Vasopressors

Contributor: Nick Tsipis, MD Educational Pearls: Epinephrine: alpha-1, alpha-2, beta-1, and beta 2 agonist - used in cardiac arrest with positive effects on ROSC in prehospital and peri-hopsital set...

22 Helmi 20218min

Podcast 641: Leadless Intracardiac Pacemaker

Podcast 641: Leadless Intracardiac Pacemaker

Contributor: Jared Scott, MD Educational Pearls: Small capsule pacemaker (2.5 cm, 1 ml volume) resides in the heart without any associated wires or leads like a traditional pacemaker The new version ...

16 Helmi 20216min

Podcast 640: Kawasaki's Disease

Podcast 640: Kawasaki's Disease

Contributor: Peter Bakes , MD Educational Pearls: Pediatric Fever + Rash Differential: scarlet fever, measles, rubella, chicken pox, fifth's disease, HHV-6, adenovirus, anaphylaxis, Kawasaki's diseas...

15 Helmi 20215min

Pharmacy Phriday #9: Xofluza (Baloxavir marboxil) for Influenza

Pharmacy Phriday #9: Xofluza (Baloxavir marboxil) for Influenza

Contributor: Rachael Duncan, PharmD BCPS Educational Pearls:  According to the Department of Public Health and Environment who puts out a weekly report on the influenza virus in Colorado, there appea...

12 Helmi 202112min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa