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..
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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Stephen B., M.D. - May 13, 2015 12:56 PM
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. - July 14, 2015 4:12 PM
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!!