Juice ’em!

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2 Responses

  1. Brian Hanrahan M.D. says:

    Great discussion. I was wondering though why intra-arterial therapy use beyond the 6 hour mark wasn’t discussed since the most recent studies (i.e. DAWN trial) showed a NNT is comparable to intervention in the first 6 hours in select populations?

    • bweditorialboard@gmail.com says:

      That is a great point Brian, and one that was brought up in post-production of the episode. Unfortunately, these and other data regarding extended time windows (notably in cases of large vessel posterior circulation disease) were not included in the short time frame allotted for the episode. Also worth noting are the alternatives to intravenous tissue plasminogen activator (e.g., desmoteplase) which may extend the time window for systemic thrombolysis, although this was not proven to be effective in the recently published results from DIAS-4. These and other therapies (like small molecule Gp IIb/IIIa inhibitors) warrant further discussion in future shows.

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