WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Monday, November 8, 2021

SGEM#349 - By admin - November 06, 2021
Reference: Katsanos et al. Utility of Intravenous Alteplase Prior to Endovascular Stroke Treatment: A Systematic Review and Meta-analysis of RCTs. Neurology 2021
CLINICAL QUESTION: WHAT IS THE BEST STRATEGY FOR TREATING PATIENTS WITH AN ACUTE LARGE VESSEL OCCLUSION STROKE, DIRECT TO MECHANICAL THROMBECTOMY OR A BRIDGING APPROACH WITH TPA FOLLOWED BY MECHANICAL THROMBECTOMY?
KEY RESULTS: NO STATISTICAL DIFFERENCE IN GOOD NEUROLOGIC OUTCOME
SGEM BOTTOM LINE: CURRENTLY THERE IS INSUFFICIENT EVIDENCE TO KNOW WHAT THE BEST STRATEGY FOR PATIENTS WITH LARGE VESSEL OCCLUSIONS IS, DIRECT TO MECHANICAL THROMBECTOMY OR BRIDGING WITH TPA.