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Paper Chase 4.5 – Intra-Arterial Stroke Might Be the Real Deal

Rob Orman, MD and Ryan Radecki, MD
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08:13
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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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01:18

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EM:RAP 2015 May Written Summary 1 MB - PDF

Paper Chase 4.5?  Yes, we had more to say.

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Stephen B., M.D. -

Outcomes refer to some patients that may have been treated with tPA followed by intra-arterial intervention within 6 hours of symptom onset who failed tPA treatment. This is contrary to the results of NIMS that showed no immediate benefit of tPA but suggested long term benefit in some patients. It is also curious that tPA would be used at all in cases with large proximal vessel stroke for the evidence presented shows no benefit from its use in this circumstance..

Jennifer M. -

This was great. What are your thoughts on pts at 5 hours (outside tpa window) and cta/mra positive for proximal lesion? Also, if we know tpa does a terrible job at dissolving proximal clots, what are your thoughts on cva pt in the 3 hour window, obtain ct/cta and if only proximal lesion, skip the tpa and do intraarterial therapy? Thanks!!

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A Totally Mental Month of Education! Full episode audio for MD edition 285:23 min - 332 MB - M4AEM:RAP 2015 May Canadian Edition Canadian 17:44 min - 24 MB - MP3EM:RAP 2015 Peut Résumé en Francais Français 59:38 min - 82 MB - MP3EM:RAP 2015 Mayo Resumen Español Español 74:07 min - 85 MB - MP3EM:RAP 2015 May Aussie Edition Australian 62:22 min - 86 MB - MP3EM:RAP 2015 May MP3 329 MB - ZIPEM:RAP 2015 May Written Summary 1 MB - PDFEM:RAP 2015 May Board Review Answers 415 KB - PDFEM:RAP 2015 May Board Review Questions 416 KB - PDFEM:RAP Español Mayo 2015 1 MB - PDF

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