Podcasts about Thrombectomy

In this episode, we explore considerations in mechanical thrombectomy for pulmonary embolism, with particular emphasis on determining appropriate endpoints for concluding a procedure and the critical role of time and procedural efficiency. Key takeaways cover optimizing procedure duration, achieving meaningful reductions in pulmonary artery pressure and clot burden, and employing strategies to minimize or prevent blood loss throughout the intervention.

We explore the world of thrombectomy for acute ischemic stroke with Justin F. Fraser (@doctorjfred), MD, FAANS, FAHA, Professor and Vice-Chair of Neurological Surgery and Director of Cerebrovascular Surgery and Neuro-interventional Radiology at University of Kentucky, where he specializes in cerebrovascular, endovascular, skull base, and endoscopic transsphenoidal surgery. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy … Continue reading "Episode 89: Thrombectomy for stroke, with Justin Fraser"

In this episode of the PFC Podcast, trauma surgeon Dr. Mark Shapiro discusses advanced trauma care techniques, including Roboa, hemorrhage control methods, and the importance of decision-making in high-stakes environments. He emphasizes the need for ongoing training and collaboration between civilian and military medical professionals to improve patient outcomes in trauma situations. The conversation also touches on the role of telemedicine in providing guidance for advanced procedures in austere settings.TakeawaysRoboa is a controversial procedure with mixed reviews.Decision-making in trauma surgery is critical and complex.Training and practice are essential for proficiency in advanced procedures.Telemedicine can enhance trauma care by providing expert guidance.Collaboration between civilian and military trauma care is vital.Alternative hemorrhage control techniques are limited but evolving.The consequences of surgical decisions can be life or death.Regular training refreshers are necessary for trauma medics.Understanding the environment is crucial for effective trauma care.Patient outcomes can improve with better training and experience.Chapters00:00 Introduction to Advanced Trauma Care02:51 Understanding Roboa and Its Implications06:11 Decision-Making in Trauma Surgery09:03 Exploring Alternative Hemorrhage Control Techniques12:03 The Role of Training and Practice in Trauma Procedures15:04 Shunts and Limb Reperfusion in Trauma18:04 Thrombectomy and Its Challenges21:03 Telemedicine in Trauma Care24:11 Collaboration Between Civilian and Military Trauma Care27:13 Recruiting and Training for Advanced Trauma ProceduresThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

On Episode 51 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the April 2025 issue of Stroke: “Clinical Severity and Outcomes in Large Infarcts With Endovascular Therapy: A Post Hoc Analysis of the ANGEL-ASPECT Trial” and “Association Between Thrombus Composition and Etiology in Patients With Acute Ischemic Stroke Treated by Thrombectomy.” She also interviews Dr. Roland Veltkamp about the PRESTIGE-AF trial, presented in February at the International Stroke Conference. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20250414.579089

PEERLESS: Large-Bore Mechanical Thrombectomy vs Catheter-directed Thrombolysis for Treatment of Intermediate-Risk Pulmonary Embolism

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from January 11-17, 2025.

Two new trials published in JAMA evaluate the efficacy of periprocedural intra-arterial thrombolytics after successful endovascular thrombectomy for patients with acute ischemic stroke. Diederik Dippel, MD, PhD, of Erasmus University Medical Center discusses this and more with JAMA Deputy Editor Christopher C. Muth, MD. Related Content: Intra-Arterial Thrombolytics During Thrombectomy for Ischemic Stroke—End of the Story or a New Beginning? Intra-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke Intra-Arterial Urokinase After Endovascular Reperfusion for Acute Ischemic Stroke

This recording features audio versions of January 2025 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Effectiveness of Track Cauterization in Reduction of Adverse Events for Lung Microwave Ablation ReadSelective Lymphatic Duct Embolization for Treatment of Thoracic Lymphatic Flow Disorders in Children: Technical Aspects and Comparison with Thoracic Duct Embolization ReadA Comparison of Postprocedural Hemoglobin in Catheter-Directed Thrombolysis versus Large-Bore Aspiration Thrombectomy for Acute Pulmonary Embolism ReadClinical Outcomes following Invasive Treatment of Femoropopliteal Artery Disease: A Retrospective Single-Center Cohort Study ReadOutcomes of Endovascular Treatment for Infectious Thoracic Aortic Diseases ReadThe Influence of Preablation Embolization Particle Size on the Size of the Microwave Ablation Zone in a Porcine Orthotopic Renal Tumor Model ReadJVIR and SIR thank all those who helped record this episode. To sign up to help with future episodes, please contact our outreach coordinator at millennie.chen.jvir@gmail.com.  Host:Manbir Singh Sandhu, University of California Riverside School of MedicineAudio editor:Manbir Singh Sandhu, University of California Riverside School of MedicineOutreach coordinator:Millennie Chen, University of California Riverside School of MedicineAbstract readers:Maximillion Hayama, Duke University School of MedicineSonya Choe, University of California Riverside School of MedicineSiddak Dhaliwal, University of Missouri School of MedicineAkumbir Singh Grewal, St. George's University School of MedicineBryan Torres, University of California Riverside School of MedicineJason Hoang, The Ohio State College of MedicineSIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

Thrombectomy for acute ischaemic stroke has undergone great advances in the last decade, but the expertise and technology is restricted to tertiary hospitals. Outside of large metropolitan centres, thrombolytic treatment can buy a patient time, but for almost 30 years the first line agent has remained unchanged. Alteplase is an analog of the human tissue plasminogen activator which activates plasmin to dissolve fibrin blood clots. For many years it was assumed that alteplase should be administered within 3 hours of symptom onset, thus it was a big deal when in 2008, research showed that that window could be safely broadened out to four and a half hours.Today's guests have over the intervening years been pushing the envelope even further, in an effort to help the more than two thirds of stroke patients who present after that threshold. In this podcast, Professors Bruce Campbell and Mark Parsons discuss a trial of the relatively novel agent, tenecteplase. The publication in the New England Journal of Medicine showed that tenecteplase could improve patient outcomes even if administered up to 24 hours out from a large vessel occlusion. The researchers explain the steps that led up to their study, and the importance of perfusion imaging to identify candidates with salvageable brain tissue. Key ReferenceTenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy [NEJM. 2024]GuestsDr Duncan Austin PhD FRACP MRCP (Cabrini Health) Professor Bruce Campbell PhD FRACP (Cabrini Health; Royal Melbourne Hospital; University of Melbourne) Professor Mark Parsons PhD FRACP, FAAHMS (Sydney Neurointerventional Specialists; Consulting in Neurology, Maitland). ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Things to Sort Out' by Walt Adams and ‘the Appalachian Trail' by Hunter Quinn. Image produced and copyrighted by RACP.Editorial feedback kindly provided by RACP physicians Stephen Bacchi, Aidan Tan, Courtney Dowd, Saion Chaterjee and David Arroyo.  Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

Abdullah Al-Abcha, MD, social media editor of JACC: Cardiovascular Interventions, and Sung Gyun Ahn, MD, PhD, discuss a recently published original research paper reporting the outcomes of failed thrombus aspiration in patients with STEMI and large thrombus burden.

Dr. Linda Chu discusses the assessment of thrombectomy vs. combined thrombolysis and thrombectomy in patients with acute ischemic stroke and medium vessel occlusion with Dr. Adam Dmytriw and Dr. Adrien Guenego.   Assessment of Thrombectomy versus Combined Thrombolysis and Thrombectomy in Patients with Acute Ischemic Stroke and Medium Vessel Occlusion. The MAD-MT Consortium. Radiology 2024; 312(2):e233041. 

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from September 21-September 27, 2024.

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome back to "Ditch the Lab Coat," the podcast where we explore the fascinating world of health and medicine with a skeptical eye. I'm Dr. Mark Bonta and In today's episode, Dr. Kaplovitch dives deep into the different types of blood clots and the importance of personalized treatment. He explains that not all blood clots are created equal - some predominantly affect the veins, while others can travel to the lungs and become life-threatening. We discuss the various risk factors that can lead to blood clot formation, from genetic conditions to long plane rides, and Dr. Kaplovitch offers practical advice on managing this complex disorder.We also touch on the fascinating history behind some blood thinning medications, like warfarin, which was originally used as rat poison! Dr. Kaplovitch clarifies the distinctions between its toxic properties and medical use. Throughout our conversation, we emphasize the importance of transparently counseling patients about the risks and benefits of different treatments. Dr. Kaplovitch highlights the abundance of research in the field of thrombosis and how it informs the personalized approach he takes with his patients.So join us as we simplify these complex medical concepts and explore the latest advancements in blood clot prevention and treatment. As always, remember that this podcast is for informational purposes only and does not substitute for professional medical advice. Let's ditch the lab coat and dive in!04:24 Experienced medical student impresses with professionalism.09:02 Blood clots can travel to lungs, fatal.12:14 Prolonged sitting at desk may increase thrombosis risk.16:01 Minority with blood clots can improve naturally.18:45 Clot busters have significant risk of bleeding.20:59 Treatment options for preventing blood clot complications.25:39 Passion for vascular medicine, citing primary literature.29:26 Newer blood thinners may have advantages.31:37 Warfarin inhibits clotting by blocking vitamin K.36:09 Balancing blood thinness for health benefits is crucial.37:22 Maintain optimal blood thinness to prevent risks.42:22 Minor bleeding from gut might not require action.46:27 Consistent blood thinner use is crucial.50:05 Discussing evolving thrombosis practices, specifically genetic testing controversies.51:24 Testing for clotting disorders requires informed discussion.57:02 Advancements in personalized medicine revolutionize treatment.58:45 Hip hop slang reference and deep thrombosis.

Can a new drug slow the progression of Alzheimer's disease? Find out about this and more in today's PeerDirect Medical News Podcast.

In this week's podcast, Neurology Today's editor-in-chief discusses data on the effectiveness of rescue therapies when endovascular thrombectomy fails, how first-seizure clinics reduce hospitalizations, and AI's use in sleep neurology.

What might yawning and sneezing be signs of in a patient? This month's podcast features new RCEM and NPIS guidance on acute opioid toxicity, outlining a number of symptoms to stay alert to. Before getting to that there's a paper on bypassing hospitals for patients needing mechanical thrombectomy, a study on how austerity affected emergency admissions across a range of UK local authorities, and some research on the immune-related adverse affects that can arise in the ED amongst oncological patients. Read the issue highlights: July 2024 Primary Survey Articles discussed in this episode: Healthcare professional views about a prehospital redirection pathway for stroke thrombectomy: a multiphase deductive qualitative study. Day J, Simmonds RL, Shaw L, et al Are local public expenditure reductions associated with increases in inequality in emergency hospitalisation? Time-series analysis of English local authorities from 2010 to 2017. Castro-Ávila AC, Cookson R, Doran T, et al Management and outcome of oncological patients under immune checkpoint inhibitors presenting at the emergency department. Pini F, Grigoriu B, Lieveke A, et al Joint RCEM and NPIS best practice guideline: assessment and management of acute opioid toxicity in adults in the emergency department. Blundell M, Gill R, Thanacoody R, et al   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Dr. Adam Striker interviews Drs. Paul Picton and Matt Whalen from the Society for Neuroscience in Anesthesiology and Critical Care, SNACC, about perioperative stroke. Hear their expert opinions on risk factors, the measurement gap, guidelines, the importance of early detection, the effectiveness of thrombectomy, and more. Recorded April 2024.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021. Originally released: May 16, 2019 It would be an understatement to say that endovascular thrombectomy has revolutionized acute stroke management. As of 2018, the American Heart Association recommends treatment up to 24 hours after time last seen normal for select patients. This week on the BrainWaves podcast, Dr. Tudor Jovin--PI for the DAWN and REVASCAT clinical trials--summarizes the history of thrombectomy trials and what it is about our current strategies that have breathed new life into a technique that has historically fizzled. Produced by James E Siegler and Jesse Thon. Music courtesy of Cuicuitte, Coldnoise, Medyn, Jon Watts, Lee Rosevere, and Mystery Mammal. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast. REFERENCES Campbell BC, Majoie CB, Albers GW, et al. Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data. Lancet Neurol 2019;18(1):46-55. Erratum in: Lancet Neurol 2019 Mar;18(3):e2. PMID 30413385Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016;387(10029):1723-31. PMID 26898852Gross BA, Jadhav AP, Jankowitz BT, Jovin TG. The ongoing revolution in thrombectomy: expanding inclusion criteria to larger cores. World Neurosurg 2018;120:393-94. PMID 30292027Heit JJ, Wintermark M. Perfusion computed tomography for the evaluation of acute ischemic stroke: strengths and pitfalls. Stroke 2016;47(4):1153-8. PMID 26965849Jadhav AP, Molyneaux BJ, Hill MD, Jovin TG. Care of the post-thrombectomy patient. Stroke 2018;49(11):2801-07. PMID 30355218Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations. AJNR Am J Neuroradiol 2009;30(5):885-92. PMID 19299489Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018;378(1):11-21. PMID 29129157Román LS, Menon BK, Blasco J, et al. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018;17(10):895-904. PMID 30264728 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Penumbra keeps a two-page list of key thrombectomy opportunities and technologies to innovate that allows it to keep transforming, presently with its computed-assisted vacuum technology (CAVT) for removing clots from the body, CEO Adam Elsesser explains to Bloomberg Intelligence. In this Vanguards of Health Care podcast episode, Elsesser sits down with BI analyst Matt Henriksson for an in-depth interview about Penumbra, how CAVT can sense the pressure differentials between clot and blood to suck clot when it's there and close the valve when not in order to limit blood loss, and how a serendipitous lunch was enough for him to adapt and expand technology originally designed for neuro cases to also treat peripheral disease, which has become Penumbra's largest and fastest-growing segment.See omnystudio.com/listener for privacy information.

Mechanical thrombectomy is an effective new procedure for ischemic stroke management that lowers the possibility of damage to brain tissue. Select hospitals designated as thrombectomy-capable stroke centers, such as UAB, are equipped to perform this time-sensitive procedure 24/7. Michael Lyerly, M.D., a vascular neurologist, and Elizabeth Liptrap, M.D., a vascular neurosurgeon, explain how improved coordination with first responders and other hospitals using telemedicine and triage allows UAB to treat more regional patients who might benefit. They describe their multidisciplinary approach to choosing a specific combination of other tools and techniques alongside mechanical thrombectomy

In this episode of DeviceTalks Weekly Co-Hosts Tom Salemi and Chris Newmarker pay a visit to the Wizard, Joe Mullings of The Mullings Group, to get his take on the disruptive force that is Intuitive's da Vinci 5. What does this mean to the surgical robotics competitors both big and small? Then Tom Salemi talks with Murali Srivathsa, CEO of Akura Medical, about the company's aggressive moves to disrupt the thrombectomy. Akura is part of the prolific Shifamed accelerator, so we'll talk about that innovative powerhouse as well as Srivathasa's own career. To register for the upcoming DeviceTalks Tuesday Surgical Robotics Week or DeviceTalks Boston go to DeviceTalks.com. Thanks for listening to the DeviceTalks Podcast Network. Subscribe now to the DeviceTalks Podcast Network on any major podcast player.

Editor's Summary by Anthony Charles, MD, MPH, Associate Editor of JAMA, the Journal of the American Medical Association, for the March 12, 2024, issue.

Editor's Summary by Christopher W. Seymour, MD, MSc, Associate Editor of JAMA, the Journal of the American Medical Association, for the March 5, 2024, issue.

In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ilan Rzadkowolsky-Raoli about his experience of being diagnosed with a large saddle embolus and subsequently being treated by his best friend, Dr. Ripal Gandhi. Dr. Rzadkowolsky-Raoli is an interventional radiologist at Palmetto General Hospital in Miami, Florida. Dr. Rzadkowolsky-Raoli discusses the impact of his diagnosis on his practice, how it has changed the way he approaches and speaks to his patients, and his advice for clinicians. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions Medtronic ClosureFast https://www.medtronic.com/closurefast6f --- SHOW NOTES 00:00 - Introduction 06:18 - Dr. Rzadkowolsky-Raoli's Personal Journey 09:41 - Diagnosis and Treatment Process 12:18 - Post-Treatment Recovery and Reflections 24:18 - Impact on Practice and Patient Care 31:45 - Final Thoughts and Appreciation --- RESOURCES Pulmonary Embolism Response Team (PERT) Consortium: https://pertconsortium.org/ Inari FlowTriever: https://www.inarimedical.com/flowtriever/

With support from our colleagues at Penumbra, learn more about the speed, safety, and simplicity of CAVT for clot detection and removal.

In this episode of the BackTable Podcast, guest host Dr. Krishna Amuluru interviews Dr. Fawaz Al-Mufti about recent trials on large core strokes and how they may impact practice. Dr. Al-Mufti is a practicing neurointerventionalist and serves as the Associate Chair of Neurology for Research at New York Medical College. Dr. Al-Mufti examines the cost-effectiveness and socioeconomic implications of successful treatment of patients with large core strokes. The doctors highlight various stroke thrombectomy trials including the RESCUE-Japan, SELECT2 Trial, and TENSION trials. The discussion also covers how these findings affect thrombectomy expansion in lower resource settings and the future outlook of endovascular thrombectomy procedures. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:53 - Large Ischemic Core Infarcts 06:06 - The Importance of ASPECTS 11:59 - Large Ischemic Core Trials 23:37 - Socioeconomic Implications of Thrombectomy 38:08 - The Future of Thrombectomy --- RESOURCES Mission Thrombectomy: https://missionthrombectomy.org/ The Alberta Stroke Program Early CT score (ASPECTS): A predictor of mortality in acute ischemic stroke: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515558/ Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomized trials (HERMES Study): https://doi.org/10.1016/S0140-6736(16)00163-X Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging (DEFUSE III Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1713973 Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct (DAWN Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1706442 Endovascular Therapy for Acute Stroke with a Large Ischemic Region (RESCUE-Japan Trial): https://www.nejm.org/doi/full/10.1056/nejmoa2118191 Trial of Endovascular Thrombectomy for Large Ischemic Strokes (SELECT2 Trial): https://www.nejm.org/doi/full/10.1056/NEJMoa2214403 TESLA Trial: Rationale, Protocol, and Design: https://www.ahajournals.org/doi/10.1161/SVIN.122.000787 Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomized trial (TENSION Trial): https://www.sciencedirect.com/science/article/pii/S0140673623020329 Evaluation of acute mechanical revascularization in large stroke (ASPECTS ⩽5) and large vessel occlusion within 7 h of last-seen-well: The LASTE multicenter, randomized, clinical trial protocol: https://pubmed.ncbi.nlm.nih.gov/37462028/ Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct (ANGEL-ASPECT Trial): https://www.nejm.org/doi/full/10.1056/NEJMoa2213379 Acute endovascular stroke therapy (Dr. Mike Chen Review): https://pubmed.ncbi.nlm.nih.gov/20535000/ Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS (European Cost Effectiveness Study): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/ Mechanical Thrombectomy Global Access For Stroke (MT-GLASS): A Mission Thrombectomy (MT-2020 Plus) Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/ Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576630/

Welcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Dr. Mike Fralick and special guest, Dr. Laiya Carayannopoulos from the Intern at Work Podcast, discuss two recent papers exploring the role of video versus direct laryngoscopy for tracheal intubation and blood pressure management post-endovascular thrombectomy after acute ... The post Episode 74 – Video Laryngoscopy for Intubation and Blood Pressure Management post-Endovascular Thrombectomy first appeared on Healthy Debate. The post Episode 74 – Video Laryngoscopy for Intubation and Blood Pressure Management post-Endovascular Thrombectomy appeared first on Healthy Debate.

Welcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Dr. Mike Fralick and special guest, Dr. Laiya Carayannopoulos from the Intern at Work Podcast, discuss two recent papers exploring the role of video versus direct laryngoscopy for tracheal intubation and blood pressure management post-endovascular thrombectomy after acute ...The post Episode 74 – Video Laryngoscopy for Intubation and Blood Pressure Management post-Endovascular Thrombectomy appeared first on Healthy Debate.

In this episode, we will explore why Thrombectomy is considered a leading stroke intervention and can contribute to the early rehabilitation and treatment of ischemic stroke. This is especially important if recognised within pre-hospital care. This is due to its effectiveness in rapidly restoring blood flow to the brain and improving patient outcome. In the episode we will explore how this intervention can restore of cerebral blood flow, the time sensitivity of the intervention, the functional recovery of patients undergoing thrombectomy, the minimally invasive approach thrombectomy takes, the collaborative care and finally the positive clinical trials showing it effectiveness.    To do this I have Kunle Ogungbemi with me. Kunle is the Clinical Lead of interventional Neuroradiology at St George's University Hospitals in London. He has also a named author on a paper examining the Hub-and-spoke model for thrombectomy service in UK NHS practice. So the data suggests that for every 9-minute delay in onset to reperfusion, 1/100 patients will have more severe disability at 90 days. In the hub-and-spoke model, proposes that patients with suspected stroke are initially taken to the nearest hyperacute stroke centre (spoke). Patients with confirmed stroke caused by LVO are then transferred to the thrombectomy centre (hub) with thrombolysis started if appropriate.  

In this episode, we review the role and indications of thrombolytics in acute ischemic stroke. The efficacy, safety, administration considerations, and cost between alteplase and tenecteplase are compared and contrasted. Key Concepts Alteplase (Activase) is a recombinant DNA version of human TPA (tissue plasminogen activator). Tenecteplase (TNKase) is similar to human TPA except it has three amino acid changes that result in a longer half-life and higher fibrin specificity. In patients with stroke, alteplase is given as a bolus followed by a 60-minute infusion. Tenecteplase is given as an IV bolus without the need for an infusion due to its longer half-life. Tenecteplase is at least as safe and effective as alteplase in acute ischemic stroke (with some studies showing greater benefit with tenecteplase). In patients with acute ischemic stroke who are candidates for mechanical thrombectomy, thrombolytics (with alteplase or tenecteplase) will still be given in patients who meet inclusion criteria and have no exclusion criteria. References Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2019 Dec;50(12):e440-e441]. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211 Campbell BCV, Mitchell PJ, Churilov L, et al. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. N Engl J Med. 2018;378(17):1573-1582. doi:10.1056/NEJMoa1716405 Kobeissi H, Ghozy S, Turfe B, et al. Tenecteplase vs. alteplase for treatment of acute ischemic stroke: A systematic review and meta-analysis of randomized trials. Front Neurol. 2023;14:1102463. Published 2023 Jan 23. doi:10.3389/fneur.2023.1102463

Editor's Summary by Anthony Charles, MD, MPH, Associate Editor of JAMA, the Journal of the American Medical Association, for the September 5, 2023, issue. Related Content: Audio Highlights

In this episode, guest host and neurointerventional surgeon Dr. Krishna Amuluru interviews triple-boarded neurointerventional surgeon, neurointensivist, and neurologist Dr. Fawaz Al-Mufti about stroke thrombectomy in special populations. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.fred-x.com/ --- SHOW NOTES Fawaz serves as an Associate Professor, Director of Neuroendovascular Surgery Fellowship & Neurocritical-Care Unit, Assistant Dean of GME research, and Vice-Chair of Neurology research at New York Medical College, Westchester Medical Center. First, we define the special populations that have been excluded from stroke thrombectomy randomized controlled trials (RCTs). These populations include octogenarian, nonagenarian, pediatric, and pregnant patients. Fawaz then recaps the landmark trials that have shaped the field of neuroendovascular surgery, beginning with the handful that were published in 2015/2016. Approaching mechanical stroke thrombectomy in patients in their 80s and 90s and the lack of existing RCT literature is also discussed. Switching gears, Fawaz then speaks on caring for pediatric patients with large-vessel occlusion (LVO). Krishna and Fawaz cover the relative rarity of pediatric LVOs, significant differences in adult vs. pediatric stroke, and what literature exists to help guide decision-making in this patient population. Krishna then asks Fawaz about mechanical stroke thrombectomy in pregnant patients. They also cover existing literature, etiologies, and their approaches to intervention. To conclude the episode, Fawaz and Krishna speak on the purposes, applications, extrapolations, and limitations of randomized-controlled trials. --- RESOURCES SVIN 2023 Annual Meeting: https://www.svin.org/i4a/pages/index.cfm?pageid=3625 IMS-III Trial 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214300 Mr. Clean Study: https://www.nejm.org/doi/full/10.1056/nejmoa1411587 REVASCAT Study: https://www.nejm.org/doi/full/10.1056/nejmoa1503780 EXTEND-IA Study: https://www.nejm.org/doi/full/10.1056/nejmoa1414792 ESCAPE Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1414905 SWIFT PRIME Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1415061 HERMES Registry: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00351-2/fulltext?rss%3Dyes Thrombolysis in Pediatric Stroke Study (TIPS): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342311/ Delay to Diagnosis in Acute Pediatric Arterial Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/strokeaha.108.519066#:~:text=Analysis%20of%20Delay%20in%20Arterial,and%2020%25%20within%206%20hours. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.036361 Recanalization Treatments for Pediatric Acute Ischemic Stroke in France (Kids-Clot): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796278 Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke: The Save ChildS Study: https://pubmed.ncbi.nlm.nih.gov/31609380/ Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee: https://jnis.bmj.com/content/14/10/1033 O-039 diameters of large vessels in children and compatibility with adult interventional stroke devices: children are not little adults: https://jnis.bmj.com/content/7/Suppl_1/A21.1 Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660626/#bib28 WEB Device from Microvention TERUMO: https://www.microvention.com/products/web-family

In this podcast, JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, speaks with Dr. Marco Colasurdo (1) and Prof. Dheeraj Gandhi (2), authors of the original research article, "Predictors for large vessel recanalization before stroke thrombectomy: the HALT score" - https://jnis.bmj.com/content/early/2023/04/25/jnis-2023-020220 This paper is free-to-access for a month following the publication of this podcast.  Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767  Thank you for listening! This episode was edited by Brian O'Toole.  (1) Interventional Neuroradiology, Dept. of Diagnostic Radiology, Uni. of Maryland Medical Center, Baltimore, Maryland, USA  (2) Dept. of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA

In this podcast, JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, speaks with Dr. Marco Colasurdo (1) and Prof. Dheeraj Gandhi (2), authors of the original research article, "Predictors for large vessel recanalization before stroke thrombectomy: the HALT score" - https://jnis.bmj.com/content/early/2023/04/25/jnis-2023-020220 This paper is free-to-access for a month following the publication of this podcast. Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767 Thank you for listening! This episode was edited by Brian O'Toole. (1) Interventional Neuroradiology, Dept. of Diagnostic Radiology, Uni. of Maryland Medical Center, Baltimore, Maryland, USA (2) Dept. of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA

Dr. Francis Deng discusses the potential benefit of thrombectomy for distal medical vessel occlusions of the anterior cerebral artery with Dr. Lukas Meyer Thrombectomy versus Medical Management for Isolated Anterior Cerebral Artery Stroke: An International Multicenter Registry Study. Meyer et al. Radiology 2023; 307(2):e220229.

Drs. Hassan Kobeissi and Alejandro Rabinstein discuss their paper, "CT Perfusion vs Noncontrast CT for Late Window Stroke Thrombectomy: A Systematic Review and Meta-analysis". Show references: https://n.neurology.org/content/early/2023/03/29/WNL.0000000000207262

Dr. Andrew Southerland talks with Dr. Alejandro Rabinstein and Hassan Kobeissi about comparing outcomes between CTP and NCCT for EVT selection in the late therapeutic window. Read the related article in Neurology®.

In this episode, host Dr. Chris Beck interviews Dr. Alexander Ushinsky about his standard workup and treatment when performing arterial thrombectomy in acute limb ischemia (ALI). --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES In the past three years, Dr. Ushinksy has focused on building up peripheral vasculature service lines at the Mallinckrodt Institute of Radiology at Washington University in St. Louis. He has acquired skills not only in treatment of ALI, but also in building referral bases and collaborating with vascular surgeons and cardiologists. To begin, we review important aspects of a focused history and physical exam. It is crucial to assess whether the patient has underlying peripheral arterial disease (PAD), other thromboembolic diseases, or underlying coagulopathies. Different etiologies of thrombus could require additional consultation with hematologists and cardiologists. Additionally, timing of symptom onset is important to consider when planning interventions in an on-call setting. Dr. Ushinsky relies on extremity pulse exams using bedside doppler and the Rutherford Classification System for ALI to ascertain whether intervention can be helpful. In cases of Rutherford class 1-2a, intervention is usually warranted. Cases that fall into class 2b may or may not require intervention, and cases in class 3 and beyond usually do not gain benefit from intervention since lower extremity paralysis and clot burden is so severe. With regards to types of interventions, Dr. Ushinsky highlights two common IR procedures– lysis catheter placement and endovascular thrombectomy. In the past, lysis catheters were the only available endovascular treatment. We walk through catheter placement, noting that in order to gain maximum benefit, the catheter should be placed across the entirety of the thrombus, with holes proximal and distal to the lesion, so that tPA can be infused throughout the clot and have appropriate inflow and outflow tracts. Good candidates for lysis catheter placement include patients who have extensive clot burden in small vessels and those who have underlying CLI that can be definitively addressed in a later procedure. A major difference between lytic catheter placement and thrombectomy is that patients receiving lytic therapy require admission to the ICU for close monitoring and frequent neurovascular checks. Next, we pivot to discussion about newer thrombectomy devices. Dr. Ushinsky describes pros and cons of common devices that are used in his practice and types of cases that would benefit from each one. Thrombectomy is useful if there is a low clot burden that can be addressed in a single session. Additionally, this procedure is more appropriate than lysis catheter placement if the patient is elderly, has had recent surgery, or is otherwise a poor candidate for systemic tPA. Dr. Ushinsky always performs a diagnostic angiogram at the beginning of the case and a completion angiogram to confirm that the lesion has been fully treated. Overall, he believes that the best intervention for a patient is the one that the practitioner feels the most adept at and can safely perform. --- RESOURCES Rutherford Acute Limb Ischemia Classification System: https://www.jvascsurg.org/article/S0741-5214(97)70045-4/fulltext#secd69653256e1488 Boston Scientific AngioJet Thrombectomy System: https://www.bostonscientific.com/en-US/products/thrombectomy-systems/angiojet-thrombectomy-system.html Penumbra Indigo Thrombectomy System: https://www.penumbrainc.com/peripheral-device/indigo-system/ AngioDynamics Auryon Thrombectomy System: https://www.angiodynamics.com/product/auryon/ Rotarex Excisional Atherectomy System: https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system Pounce Thrombectomy System: https://pouncesystem.com/ Find this episode on BackTable.com to see the full list of resources.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.Originally released: April 2, 2020Perfusion imaging employs concepts that date back to the early 1830s, and it leverages hardware and software that emerged around the same time as multidetector helical CT scans. But it has only become popular in recent years for thrombectomy decision-making. If I'm being honest, I often never use it for this purpose. So what other purposes might it serve? And how does it work? This week, we review the fundamental concepts of perfusion CT, its utility in stroke care, and how it might prove useful for other neurologic conditions as well.Produced by James E Siegler. Music courtesy of Julie Maxwell, John Bartmann, Kai Engel, and Pachyderm. Our theme song was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Some of the voices you heard throughout the program were those of Dr. Mathias Prokop, Radbound Medical Center, Netherlands; Terri Yeager, Comprehensive Stroke Program Coordinator at Cooper University Hospital; and a recording that was produced by GE Healthcare, which is freely available on YouTube. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.REFERENCESAlbers GW, Marks MP, Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med 2018;378(8):708-18. PMID 29364767Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet 2000;355(9216):1670-4. PMID 10905241Boned S, Padroni M, Rubiera M, et al. Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept. J Neurointerv Surg 2017;9(1):66-9. PMID 27566491Campbell BC, Christensen S, Levi CR, et al. Comparison of computed tomography perfusion and magnetic resonance imaging perfusion-diffusion mismatch in ischemic stroke. Stroke 2012;43(10):2648-53. PMID 22858726Campbell BC, Weir L, Desmond PM, et al. CT perfusion improves diagnostic accuracy and confidence in acute ischaemic stroke. J Neurol Neurosurg Psychiatry 2013;84(6):613-8. PMID 23355804Campbell BCV, Ma H, Ringleb PA, et al. Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. Lancet 2019;394(10193):139-147. PMID 31128925Mangla R, Ekhom S, Jahromi BS, Almast J, Mangla M, Westesson PL. CT perfusion in acute stroke: know the mimics, potential pitfalls, artifacts, and technical errors. Emerg Radiol 2014;21(1):49-65. PMID 23771605Martins N, Aires A, Mendez Bet al. Ghost Infarct core and admission computed tomography perfusion: redefining the role of neuroimaging in acute ischemic stroke. Interv Neurol 2018;7(6):513-21.

In Part 3 of a 3-part series, Sunil A. Sheth, MD, discusses his article, "Mechanical Thrombectomy for Acute Ischemic Stroke" from the April Continuum Cerebrovascular Disease issue. This article and accompanying Continuum Audio interview are available to subscribers at continpub.com/MechThromb. This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

In Part 2 of a 3-part series, Sunil A. Sheth, MD, discusses his article, "Mechanical Thrombectomy for Acute Ischemic Stroke" from the April Continuum Cerebrovascular Disease issue. This article and accompanying Continuum Audio interview are available to subscribers at continpub.com/MechThromb. This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

In Part 1 of a 3-part series, Sunil A. Sheth, MD, discusses his article, "Mechanical Thrombectomy for Acute Ischemic Stroke" from the April Continuum Cerebrovascular Disease issue. This article and accompanying Continuum Audio interview are available to subscribers at continpub.com/MechThromb. This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

Frank chats with neurointerventional radiologist Nathan Manning about how stroke management has evolved over the decades and the expanding role of endovascular clot retrieval. He gets a gold badge.  SELECT2 ► https://www.nejm.org/doi/pdf/10.1056/NEJMoa2214403 Radiopaedia 2023 Virtual Conference ► https://radiopaedia.org/courses/radiopaedia-2023-virtual-conference Become a supporter ► https://radiopaedia.org/supporters Get an All-Access Pass ► https://radiopaedia.org/courses/all-access-course-pass Andrew's Twitter ► https://twitter.com/drandrewdixon Frank's Twitter ► https://twitter.com/frankgaillard Ideas and Feedback ► podcast@radiopaedia.org   The Reading Room is a radiology podcast intended primarily for radiologists, radiology registrars and residents. 

Among several highlights of the recent International Stroke Conference was new evidence supporting endovascular thrombectomy for patients with so-called “large core” ischemic strokes. In current practice, thrombectomy is considered for patients with occlusions of the internal carotid or middle cerebral artery who are less than 24 hours since the last known well and have a small “core” of ischemia on non-contrast head CT or CT or MR perfusion imaging -- in other words, there's radiographic evidence that only a small core of the brain has suffered permanent injury and a larger penumbra of tissue can be saved. SELECT-2 is a multicenter randomized controlled trial that examined whether patients with LARGE cores of ischemic tissue could ALSO benefit from thrombectomy. On our show today we have SELECT-2 principal investigator Dr. AM-rou sou-RAJ, who is also Professor of Neurology at Case Western Reserve University School of Medicine. He was interviewed by Dr. Michelle Johansen, vascular neurologist at Johns Hopkins University, about what the study results might mean for stroke care -- and stroke imaging -- going forward. Series 4, Episode 6. Featuring: Guest: Amrou Sarraj, MD FAHA, Professor of Neurology, Case Western Reserve University School of Medicine, George M. Humphrey II Endowed Chair, University Hospitals Neurological Institute, Director, Comprehensive Stroke Center and Stroke Systems, University Hospitals Interviewer: Dr. Michelle Johansen, Johns Hopkins Medicine Producer: Dr. Joseph Carrera, University of Michigan Disclosures: Dr. Sarraj discloses the following relationships: SELECT2 principal investigator - funded by Stryker Neurovascular with research grant to University Hospitals Cleveland Medical Center and UT McGovern Medical School SELECT principal investigator - funded by Stryker Neurovascular with research grant to UT McGovern Medical School Member, Speaker bureau and advisory board - Stryker Neurovascular Provided advisory services to AstraZeneca, Genentech and Lumosa Theraputics

In this podcast, JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, speaks with Dr. Kyle Fargen(1) about the recently published study "Mechanical thrombectomy decision making and prognostication: Stroke treatment Assessments prior to Thrombectomy In Neurointervention (SATIN) study" - https://jnis.bmj.com/content/early/2023/01/05/jnis-2022-019741.long Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767 Thank you for listening! This episode was edited by Brian O'Toole. (1) Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA

Interview with Amrou Sarraj, MD, author of Association of Endovascular Thrombectomy vs Medical Management With Functional and Safety Outcomes in Patients Treated Beyond 24 Hours of Last Known Well: The SELECT Late Study. Hosted by Cynthia E. Armand, MD. Related Content: Association of Endovascular Thrombectomy vs Medical Management With Functional and Safety Outcomes in Patients Treated Beyond 24 Hours of Last Known Well

Prof. Urs Fischer discusses his paper, "Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke: an open-label, blinded-outcome, randomised non-inferiority trial". Show references: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00537-2/fulltexthttps://www.sciencedirect.com/science/article/abs/pii/S0140673622005372?dgcid=coauthor#! This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

Dr. Dan Ackerman talks with Prof. Urs Fischer about the use of thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with acute ischemic stroke.   This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.