NeurovascularMedicine.com
The contents are under continuing development and improvements and may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website.

A

Welcome and Introduction


Latest news and Developments

November 2015:Mechanical Thrombectomy

Currently in the UK and I am sure Worldwide, delivering Mechanical thrombectomy is the current focus of attention and the challenge is to deliver robust clinical pathways to allow it to be offered to stroke patients quickly and safely. Here is an interesting paper from 2012 and here is Consensus statement from the European Stroke Organisation. It will be interesting times ahead. Here is an interesting read the PISTE or Pragmatic Ischaemic Stroke Thrombectomy Evaluation study run by Keith Muir. For those not aware of the typical selection criteria it will be those age >18 years with NIHSS ≥ 6 and No Major Contraindication and Eligible for IV rtPA who will be given standard IV rtPA 0.9mg/kg and then either MRA/CTA/DSA looking for ICA-T, MCA M1 or M2 occlusion and then randomized to receive completion of alteplase or Additional mechanical thrombectomy IA Device selected as per Neurointerventionalist. Assessment will be early major neurological improvement as per NIHSS and mRS at 3m.

I know large teaching centres are getting on with their plans and are at varying stages. It is going to be a significant amount of additional work for a tertiary centre in a time when there is no money to go around. Do we need to go down the route of the cardiology PCI model. Should I be asking my cardiology colleagues to go north.


Note: The plan is to keep the website free through donations and advertisers that do not present any conflicts of interest. I am keen to advertise courses and conferences. If you have found the site useful or have any constructive comments please write to me at drokane (at) gmail.com. I keep a list of patrons to whom I am indebted who have contributed. If you would like to advertise a course or conference then please contact me directly for costs and to discuss a sponsored link from this site.

free web counter