Episode 313: 312. Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size

Episode 313: 312. Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size

https://www.nejm.org/doi/10.1056/NEJMoa2314063

Randomized trials have shown the benefit of endovascular thrombectomy in patients with acute stroke due to large-artery occlusion in the anterior circulation and a large baseline infarct (core) In these trials,1-5 a large core was defined by an ASPECTS value of 5 or less, but because of concerns about the deleterious effects associated with the reperfusion of large infarcts,8 patients with the largest infarcts (ASPECTS value, 0 or 1) were excluded from enrollment

Now, researchers have compared EVT plus medical therapy to medical therapy alone in patients who could be treated within 6.5 hours of stroke onset and had a large amount of ischemic tissue

The primary outcome was the modified Rankin scale (mRS) score and the major safety outcome was all-cause mortality, both at 90 days.

a 3-year period, 333 patients cerebral vessel occlusion in the anterior circulation

The median NIH Stroke Scale score was 21, and the median baseline infarct volume was 135 mL;

Median time to randomization was 270 minutes after symptom onset. The EVT group had a lower median mRS score at 90 days than the medical-therapy group (4 vs. 6) and also lower mortality (36% vs. 56%).

The overall rate of death or dependency (mRS score ≥4) at 90 days was high in both groups but lower with thrombectomy (67% vs. 88%). NNT of 5

Symptomatic intracranial hemorrhage was more common with EVT (9.6% vs. 5.7%).—NNH of 25

Jaksot(385)

Episode 407: 415. Do Air Filters Lower Blood Pressure?

Episode 407: 415. Do Air Filters Lower Blood Pressure?

https://pubmed.ncbi.nlm.nih.gov/40767818/This is a great example for students and residents to look and see that the abstract does not always match what the paper actually says

12 Marras 20259min

Episode 406: 414. Resistant Hypertension, Physical Therapy, Steroids for Pneumonia

Episode 406: 414. Resistant Hypertension, Physical Therapy, Steroids for Pneumonia

Efficacy and safety of Baxdrostat in uncontrolled and resistant hypertension compared to placebo in phase three when there are MRA available that are cheap and availableA randomised trial of physical ...

3 Marras 202515min

Episode 405: 413. 4 Articles to Scare You-- COPD, Cirrhosis, ETOH, and Ablation

Episode 405: 413. 4 Articles to Scare You-- COPD, Cirrhosis, ETOH, and Ablation

gabapentin may increase COPD exacerbationsBenzo for ETOH might be long gone..guess what is going to replace itAnticoagulation after ablation.... what do you do with it?BBlocker in those with cirrhosis...

31 Loka 202518min

Episode 404: 412. Liver Transplant - The One Referral I Doubt You Are Doing Correctly

Episode 404: 412. Liver Transplant - The One Referral I Doubt You Are Doing Correctly

Clinicians should refer patients for liver transplant evaluation after any decompensation event—such as ascites or variceal bleeding—regardless of MELD score. After a first decompensation, 5-year mort...

24 Loka 20257min

Episode 403: 411. Gabapentin and Emergency Carotid Artery Stenting in Stroke

Episode 403: 411. Gabapentin and Emergency Carotid Artery Stenting in Stroke

Study Summary: Emergent Carotid Stenting in Acute Stroke ThrombectomyA multicenter registry study in Catalonia (2017–2023) evaluated outcomes in 578 patients with acute ischemic stroke and tandem lesi...

22 Loka 202510min

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

This massive meta-analysis of 484 randomized, double-blind, placebo-controlled trials (104,176 participants) quantified the blood pressure–lowering effects of major antihypertensive drug classes and t...

16 Loka 20258min

Episode 401: 409. The Effects of Upper Extremity and Lower Extremity Aerobic Exercise Training in Patients with Peripheral Arterial Disease:

Episode 401: 409. The Effects of Upper Extremity and Lower Extremity Aerobic Exercise Training in Patients with Peripheral Arterial Disease:

Practice Pearls: “Skip Leg Day” (Sometimes)For PAD patients who can’t tolerate leg workouts, upper body aerobic training is a strong, evidence-backed alternative. It’s not just a workaround—it’s a wor...

14 Loka 20257min

Episode 400: 408. CME Obesity and MASH

Episode 400: 408. CME Obesity and MASH

GLP1 drugs work but they likely need lifestyle modificationsNo convincing evidence GLP1 cause thyroid cancer in humans BUT contraindication if family history existStopping therapy usually results in w...

27 Syys 20251h 2min

Suosittua kategoriassa Terveys ja hyvinvointi

unicast
psykopodiaa-podcast
tiedenaiset-podcast
voi-hyvin-meditaatiot-2
vakeva-elama-viisaampi-mieli-vahvempi-keho
rss-pitaisko-erota
rss-pt-paahtio
rss-narsisti
puhu-muru
rss-kuumilla-aalloilla
meditaatiot-suomeksi
selviytyjat-tarinoita-elamasta
terapiassa
rss-nautinto
junnut-pelissa
rss-uplevel-by-sonja-hannus
rss-addiktit
rss-mighty-finland-podcast
rss-en-saa-unta
rss-fitissa-podcast