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Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (Mobile Stroke Unit--TASTE-A): protocol for a prospective randomised, open-label, blinded endpoint, phase II superiority trial of tenecteplase versus alteplase for ischaemic stroke patients presenting within 4.5 hours of symptom onset to the mobile stroke unit
Introduction Mobile stroke units (MSUs) equipped with a CT scanner are increasingly being used to assess and treat stroke patients’ prehospital with thrombolysis and transfer them to the most appropriate hospital for ongoing stroke care and thrombectomy when indicated. The effect of MSUs in both reducing the time to reperfusion treatment and improving patient outcomes is now established. There is now an opportunity to improve the efficacy of treatment provided by the MSU. Tenecteplase is a potent plasminogen activator, which may have benefits over the standard of care stroke lytic alteplase. Specifically, in the MSU ...
Source: BMJ Open - April 29, 2022 Category: General Medicine Authors: Bivard, A., Zhao, H., Coote, S., Campbell, B., Churilov, L., Yassi, N., Yan, B., Valente, M., Sharobeam, A., Balabanski, A., Dos Santos, A., Ng, F., Langenberg, F., Stephenson, M., Smith, K., Bernard, S., Thijs, V., Cloud, G., Choi, P., Ma, H., Wijeratne, Tags: Open access, Neurology Source Type: research

Using body cameras to quantify the duration of a Code Stroke and identify workflow issues: a continuous observation workflow time study
Conclusions Codes are time intensive. Time spent on decision-making was a relatively small component of the overall Code duration. Data from body cameras can provide granular data on all aspects of Code workflow to inform potential areas for improvement at individual centres.
Source: BMJ Open - January 25, 2023 Category: General Medicine Authors: Wong, J. Z. W., Park, P. S. W., Frost, T., Stephens, K., Newk-Fon Hey Tow, F. K., Garcia, P. G., Senanayake, C., Choi, P. M. C. Tags: Open access, Neurology Source Type: research

Economic evaluation of endovascular treatment for acute ischaemic stroke in Thailand
Conclusions EVT represents good value for money in the Thai context, both when provided to patients eligible for intravenous alteplase, and when provided alone to those who are ineligible for intravenous alteplase.
Source: BMJ Open - September 27, 2022 Category: General Medicine Authors: Rattanavipapong, W., Worakijthamrongchai, T., Soboon, B., Luankongsomchit, V., Kongmuangpuk, M., Isaranuwatchai, W., Teerawattananon, Y., Nilanont, Y. Tags: Open access, Health economics Source Type: research

Cost-effective analysis of mechanical thrombectomy alone in the treatment of acute ischaemic stroke: a Markov modelling study
Conclusions MT alone was cost-effective compared with MT with alteplase in China. However, cautions are needed to extend this conclusion to regions outside of China.
Source: BMJ Open - April 6, 2022 Category: General Medicine Authors: Han, M., Qin, Y., Tong, X., Ji, L., Zhao, S., Liu, L., Chen, J., Liu, A. Tags: Open access, Health economics Source Type: research