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Cost-effectiveness of endovascular thrombectomy with alteplase versus endovascular thrombectomy alone for acute ischemic stroke secondary to large vessel occlusion
CMAJ Open. 2023 May 16;11(3):E443-E450. doi: 10.9778/cmajo.20220096. Print 2023 May-Jun.ABSTRACTBACKGROUND: Recent randomized trials have suggested that endovascular thrombectomy (EVT) alone may provide similar functional outcomes as the current standard of care, EVT combined with intravenous alteplase treatment, for acute ischemic stroke secondary to large vessel occlusion. We conducted an economic evaluation of these 2 therapeutic options.METHODS: We constructed a decision analytic model with a hypothetical cohort of 1000 patients to assess the cost-effectiveness of EVT with intravenous alteplase treatment versus EVT alo...
Source: cmaj - May 16, 2023 Category: General Medicine Authors: Zhikang Ye Ting Zhou Mengmeng Zhang Junwen Zhou Feng Xie Michael D Hill Eric E Smith Jason W Busse Yi Zhang Ying Liu Xin Wang Zhuo Ma Zhuoling An Source Type: research

In acute ischemic stroke, early IV tenecteplase was noninferior to alteplase for excellent functional outcome
Ann Intern Med. 2022 Nov 1. doi: 10.7326/J22-0090. Online ahead of print.ABSTRACTMenon BK, Buck BH, Singh N, et al. Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. Lancet. 2022;400:161-9. 35779553.PMID:36315948 | DOI:10.7326/J22-0090
Source: Annals of Internal Medicine - October 31, 2022 Category: Internal Medicine Authors: Emma Ferguson Eddy Lang Source Type: research

E-011 Factors influencing thrombectomy decision-making for primary medium vessel occlusion stroke
ConclusionsMost physicians in this survey would treat MeVO stroke patients immediately with EVT, supporting the need for more robust clinical evidence.Disclosures P. Cimflova: None. M. Kappelhof: None. N. Singh: None. N. Kashani: None. J. Ospel: None. R. McDonough: None. A. Demchuk: None. B. Menon: None. N. Sakai: None. M. Chen: 2; C; Medtronic, Genentech, Stryker, Microvention, Cerenovus, Penumbra. J. Fiehler: 1; C; Acandis, Medtronic, Microvention, Stryker. 2; C; Acandis, Codman, Cerenovus, Microvention, Medtronic, Penumbra, Phenox, Stryker. M. Goyal: 2; C; Medtronic, Microvention, Stryker, GE Healthcare, Mentice.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Cimflova, P., Kappelhof, M., Singh, N., Kashani, N., Ospel, J., McDonough, R., Demchuk, A., Menon, B., Sakai, N., Chen, M., Fiehler, J., Goyal, M. Tags: Electronic poster abstracts Source Type: research

Analysis of Thrombolysis Process for Acute Ischemic Stroke in Urban and Rural Hospitals in Nova Scotia Canada
Conclusions: Guidelines and clear protocols are critical in reducing treatment times and ensuring consistent access to treatment. The majority of treatment delays encountered are system delays, which can be appropriately planned for to reduce delays within the care pathway. There is a general consensus that there is an urban-rural treatment gap for acute ischemic stroke patients in Nova Scotia, and that continuing education is key in rural hospitals to improve Emergency Department (ED) physician comfort with treating patients with tPA.
Source: Frontiers in Neurology - March 15, 2021 Category: Neurology Source Type: research

Improving Door-to-needle Times in the Treatment of Acute Ischemic Stroke Across a Canadian Province: Methodology
Background: Alteplase is a proven medical treatment for acute ischemic stroke; however, the effectiveness of this treatment is highly time dependent. Therefore, it is imperative that hospitals treat acute ischemic stroke patients as quickly as possible. The measure, door-to-needle time, is the time from hospital arrival to when alteplase administration begins. Objective: The goal in the Canadian province of Alberta was to reduce the door-to-needle time to a median of 30 minutes and to increase the percent of patients treated within 60 minutes to 90%. Overview of Methodology: A modified version of Institute for Heal...
Source: Critical Pathways in Cardiology - February 13, 2019 Category: Cardiology Tags: Pathway Source Type: research

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