Search Results for: Endovascular

How Much Money Is Wasted By Endovascular Treatment for Stroke?

If you recall, last year was a bumper crop of prospective, randomized, controlled trials testing the efficacy of endovascular devices versus tPA alone for acute ischemic stroke.  These trials – SYNTHESIS, MR-RESCUE, and IMS-III – were unified by demonstrating no additive benefit.  Of course, these trials proved nothing to proponents of endovascular therapy, owing to … Continue reading “How Much Money Is Wasted By Endovascular Treatment for Stroke?”

Maddening Lack of Perspective in Endovascular Stroke Therapy

Despite three negative trials in the New England Journal of Medicine last year, accompanied by an editorial calling for a moratorium on reimbursement for endovascular therapy for acute stroke, proponents of this therapy forge ahead.  The negative trials, at the very least, have encouraged researchers to recognize – where tPA advocates fail to see – … Continue reading “Maddening Lack of Perspective in Endovascular Stroke Therapy”

HIAT-2 for Prognosticating Outcomes After Endovascular Interventions in Stroke: Proving Once Again Sick People are Sick

A guest post by Rory Spiegel (@CaptainBasilEM) who blogs on nihilism and the art of doing nothing at emnerd.com. Since the publication of IMS-3, SYNTHESIS and MR RESCUE in the NEJM earlier this year, proponents of endovascular interventions for acute ischemic stroke have hypothesized why these trials were universally negative. Among the various explanations, one … Continue reading “HIAT-2 for Prognosticating Outcomes After Endovascular Interventions in Stroke: Proving Once Again Sick People are Sick”

HIAT-2 for Prognosticating Outcomes After Endovascular Interventions in Stroke: Proving Once Again Sick People are Sick

A guest post by Rory Spiegel (@CaptainBasilEM) who blogs on nihilism and the art of doing nothing at emnerd.com. Since the publication of IMS-3, SYNTHESIS and MR RESCUE in the NEJM earlier this year, proponents of endovascular interventions for acute ischemic stroke have hypothesized why these trials were universally negative. Among the various explanations, one … Continue reading “HIAT-2 for Prognosticating Outcomes After Endovascular Interventions in Stroke: Proving Once Again Sick People are Sick”

More Endovascular Junk Science

So far, we’ve seen nothing but poor outcomes in endovascular cerebral reperfusion trials.  The MERCI devices were simply dysfunctional and lethal and, despite advances with newer devices, we’re still waiting for a decisive trial demonstrating clear benefit.  But, the money is out there for the taking if the science will support it – and thus, … Continue reading “More Endovascular Junk Science”

Update to Start 2024

A brief post collating a few bits of my various work published across the interwebs …. The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Naturally, there are continuing Journal Club features, covering the following articles: I should also point out a couple … Continue reading “Update to Start 2024”

2021 Wrap-Up

A few items to collate from the last several months’ efforts. The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We … Continue reading “2021 Wrap-Up”

Settling the Thrombolysis Before Thrombectomy Question

… taking a quick break from combating misinformation in our age of public health emergency to note this important non-COVID-19 article from the New England Journal of Medicine. Today’s question: is alteplase necessary prior to endovascular thrombectomy in acute ischemic stroke? “It depends”. This isn’t the first study to hit the light of day, but … Continue reading “Settling the Thrombolysis Before Thrombectomy Question”

Potpourri

Just a quick-hit collection of articles I’ve wanted to highlight/catalogue for future reference, but couldn’t find the time for deep dives into each: Shared Decision Making in Patients With Suspected Uncomplicated Ureterolithiasis: A Decision Aid Development Study. For this common clinical scenario in the Emergency Department, the authors have developed a patient-facing packet to facilitate … Continue reading “Potpourri”

2019 Early Management of Acute Ischemic Stroke

Well, it’s 2019 – for another couple months – so there’s still time to update your Early Management of Acute Ischemic Stroke. For what would otherwise sound to be a potentially underwhelming interval update, there is, in fact, a ton to unpack in here. Institutional stroke committees and regional EMS systems thrive on constant change, … Continue reading “2019 Early Management of Acute Ischemic Stroke”