The Overrun

Episode 103: Updates in Stroke Care

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Drs. Mike and Mike join Ed to discuss updates in prehospital stroke care. Are we using the right stroke scale for our patients? Are we taking them to suitable hospitals? The gang discusses stroke care in 2023 and where we can go from here.

From the episode notes:

Treatment of LVO patients

  1. Thrombolytics (tPA, tenecteplase)
  2. Mechanical thrombectomy discussion
    1. a)  NNT 2.5
    2. b)  NNT= # needed to treat (how many people receive medicine before there is a benefit)
    3. Aspirin NNT is 64
    4. Benefits of mechanical thrombectomy
      1. a)  Significantly reduced mRS
      2. b)  Longer treatment window (up to 24 hours)
      3. c)  Net monetary benefit $95-175 million USD(1) Discuss net monetary benefit(2) tPA alone $72-135 million USD
      4. d)  Gained quality of life years 2
      5. Potential Harms
        1. a)  New intracranial hemorrhage
        2. b)  Access site problems
        3. c)  New embolization

          4. Rankin Scale Calculator

          Mechanical Thrombectomy for Acute Ischemic Stroke Paper

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