Case Report Evan Leibner, MD, PhD Emergency Medicine, PGY 3 Stony Brook University Medical Center.

Slides:

Advertisements

Similar presentations

Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times Michael D. Hill.

Advertisements

Beyond the Basics of Stroke Evaluation

Disclosures: Maximo C. Kiok, M.D. Medical Director of Stroke Program Trinity Health System.

Solitaire FR Revascularization Device™ Jeffrey McCarthy BME181 University of Rhode Island.

The Future of Stroke James D. Fleck, M.D. Medical Director IU Health Methodist Hospital Comprehensive Stroke Center.

Maximizing IV Thrombolytic Therapy in Acute Ischemic Stroke Kamakshi Lakshminarayan, MD PhD Assistant Professor Neurology & Epidemiology University of.

Hypertension and The Kidney Update: Clinical Trials Paul J. Scheel, Jr., M.D. Director, Division of Nephrology The Johns Hopkins University School of Medicine.

Current and Future Perspectives on Acute Coronary Syndromes Paul W. Armstrong MD AMI Quebec Montreal October 1, 2010.

Anticoagulation in Acute Ischemic Stroke. TPA: Tissue Plasminogen Activator 1995: NINDS study of TPA administration Design: randomized, double blind placebo-controlled.

TOTAL Stroke in the TOTAL trial: Randomized trial of manual aspiration Thrombectomy in STEMI TOTAL Trial Investigators.

J. Stephen Huff, MD, FACEP J. Stephen Huff, MD Associate Professor Department of Emergency Medicine University of Virginia Charlottesville, Virginia.

T-PA in Treatment of Acute Stroke: What We Know From NINDS 2004 vs 2000 Sidney Starkman, MD Departments of Emergency Medicine and Neurology, UCLA UCLA.

Acute Ischemic Stroke Management: 2004 Emergency Medicine Perspectives.

Interventional Stroke Treatment 2015

European Stroke intervention Guidelines ESMINT/ESO/ESNR/EAN WLNC 2015

TELEMEDICINE AND RESEARCH. THE TELEICTUS PROJECT IN THE HOSPITAL St JOHN OF GOD´S OF ALJARAFE. Antonio Fernández Moyano MD. PhD. Internal Medicine Service.

Endovascular Therapy for Acute Ischemic Stroke ML006 Rev01.

Evidence in the ED Byron Drumheller, MD Penn Emergency Medicine.

Overview of new acute stroke trials Shawna Cutting, MD, MS Rush University Medical Center June 9, 2015.

Impact of early surgery vs conventional treatment for infective endocarditis on mortality and embolic events: data from EASE trial Prospective RCT ( );

Simple CBF grading based on MR perfusion to anticipate long-term clinical outcome in severe stroke patients due to the carotid artery occlusion Mori T,

Edward C. Jauch, MD, MS FACEP 1 Research Horizons in the Acute Management of ICH.

Consensus of ICAD treatment after SAMMPRIS in China Zhujiang Hospital Zhujiang Hospital Nanfang Medical University Liu Yajie, MD Pros &Cons of PTAS in.

VBWG OASIS-6 The Sixth Organization to Assess Strategies in Acute Ischemic Syndromes trial.

Long-term clinical outcome following emergency MR-based reperfusion therapy for acute middle cerebral artery occlusion Department of Stroke Treatment,

Morphological and clinical results of invasive intra-arterial recanalization in the event of an acute stroke I Gubucz, Z Berentei, M Marosfői, C Óváry,

A multimodal step-up approach as rescue therapy of ischemic stroke L. Verganti, S. Vallone, C. Moratti, M. Malagoli, P. Carpeggiani Department of Neuroscience,

Time Is Brain: Advanced Stroke Treatment Grahame C Gould, MD Jefferson Neurosurgical Associates at Main Line Health, Bryn Mawr Hospital Division of Neurovascular.

Rikki Weems, PGY III August 20, 2015

ACUTE TREATMENT OF STROKE: RECENT ADVANCES AND PERFORMANCE AT CAMPBELLTOWN ALEX BUTTFIELD ED STAFF SPECIALIST.

Date of download: 5/31/2016 Copyright © The American College of Cardiology. All rights reserved. From: Mechanical Thrombectomy for Acute Ischemic Stroke:

Training Guidelines for Endovascular Ischemic Stroke Intervention: An International Multi-Society Consensus Document EJMINT Editorial, 2016:

Broward EMS Stroke Coalition Brijesh P Mehta, M.D. NeuroInterventional Surgeon Director, Stroke & Neurocritical Care Memorial Neuroscience Institute.

(p for noninferiority = 0.01)

Treating Acute Ischemic Stroke, Can We Open Up the Time Window？

ACUTE ISCHEMIC STROKE Olajide Williams, MD MS.

Table 1: Table 2: Non Therapeutic Angiograms in Acute Ischemic Stroke Patients Being Considered for Endovascular Treatment Does not Adversely Affect Patient.

Erik Oltmann, PGY-1 August 20, 2015

Thrombectomy in Acute Stroke

Sameer A. Ansari, MD, PhD Associate Professor

Clinical Audit of Head CT in Stroke Alert Cases: Role of Radiology Resident and CT Technologist Awareness in improving Head CT reporting time K Hooda,

CORAL Trial design: Patients with renal artery stenosis and hypertension or chronic kidney disease were randomized to renal artery stenting (n = 467) vs.

Concerns with Catheter Directed TPA for the Treatment of PEs

Cardiovascular Research Technology Conference (CRT 17)

SOCRATES Trial design: Patients with acute ischemic stroke were randomized in a 1:1 fashion to receive either ticagrelor 180 mg load + 90 mg BID or aspirin.

Mallinckrodt Institute of Radiology Washington University in St. Louis

Mechanical thrombectomy

Icahn School of Medicine Mount Sinai Hospital

Update from education committee

EUCLID Trial design: Patients with peripheral arterial disease (PAD) were randomized to ticagrelor 90 mg twice daily (n = 6,930) vs. clopidogrel 75 mg.

The New Frontier In Stroke Care – Endovascular Intervention

PROACT-4 Trial design: Patients enroute to the hospital with acute chest pain were randomized to point of care troponin testing (n = 305) vs. usual care.

INOVATE-HF Trial design: Patients with heart failure (HF) were randomized to device implant for vagus nerve stimulation (n = 436) versus optimal medical.

PARTNER 2A Trial design: Intermediate-risk patients with aortic stenosis (STS PROM score 4-8%) were randomized to undergo either TAVR or SAVR, stratified.

Compare-Acute Trial design: STEMI patients undergoing primary PCI were randomized to fractional flow reserve (FFR)-guided complete revascularization (n.

ALPS Trial design: Patients with adult nontraumatic out-of-hospital cardiac arrest (OOHCA) and persistent or recurrent VT/VF after ≥1 shock were randomized.

SIGNIFY Trial design: Participants with stable coronary artery disease without clinical heart failure and resting heart rate >70 bpm were randomized to.

Update from education committee

Modified Rankin score 0-2

% Heparin + GPI IIb/IIIa Bivalirudin +

TACTICS-HF Trial design: Patients with acute heart failure (reduced or preserved ejection fraction) were randomized to tolvaptan 30 mg at 0, 24, and 48.

CTA Collaterals vs CT Perfusion CBF Maps for

Extended Window Thrombectomy

Update from education committee

Update from education committee

MOMENTUM 3 Trial design: Patients with advanced heart failure were randomized to a centrifugal-flow pump (n = 152) vs. an axial-flow pump (n = 142). Results.

(p for noninferiority = 0.01)

Suggested imaging protocols for patients presenting with acute stroke symptoms based on the clinical scenario and the therapeutic options considered and.

Improving Management of Acute HTN in Patients With Stroke

Update from education committee

Presentation transcript:

Case Report Evan Leibner, MD, PhD Emergency Medicine, PGY 3 Stony Brook University Medical Center

DDx

Work Up?

REFERENCES

Locked-in Syndrome Acute basilar artery Stroke

What does the Literature say?

The early years No Benefit or Harm

Berkhemer OA, Fransen PS, Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke (MR CLEAN). N Engl J Med. 2015;372:(1) MR Clean

Campbell BC, Mitchell PJ, Kleinig TJ, et al. Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection (EXTEND-IA). N Engl J Med. 2015;372: EXTEND-IA

Goyal M, Demchuk AM, Menon BK, et al. Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke (ESCAPE). N Engl J Med. 372: ESCAPE

Saver JL, Goyal M, Bonafe A, et al. Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke. (SWIFT PRIME) N Engl J Med SWIFT PRIME

Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. (REVASCAT) N Engl J Med. 2015; REVASCAT

AHA Guidelines

Conclusions But, for the first time ever, if I were to have one of these specific types of heavily disabling strokes, this is probably the first advanced stroke intervention I'd willingly choose -Ryan Radecki