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J Neurointerv Surg. 2016 May;8(5):443-6. doi: 10.1136/neurintsurg-2015-012231. Epub 2016 Jan 12.

Does the use of IV tPA in the current era of rapid and predictable recanalization by mechanical embolectomy represent good value?

Author information

1
Department of Imaging, Monash Imaging, Monash Health, Melbourne, Victoria, Australia Stroke and Ageing Research Centre, Department of Medicine, Monash University, Melbourne, Victoria, Australia.
2
NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
3
Memorial Neuroscience Institute, Hollywood, Florida, USA.
4
Departments of Radiology, Neurology and Neurological Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
5
Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
6
Neuroradiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA.

Abstract

As healthcare delivery in the USA transforms into a model that at its core requires value-based considerations, ischemic stroke is confronted by intersecting forces. Modern techniques allow rapid revascularization in the majority of patients with large vessel occlusions. Dramatic advances in the evidentiary basis for mechanical embolectomy are increasing the number of patients treated with this therapy. A key part of the therapeutic arsenal in many patients treated with interventional techniques has been concurrent intravenous thrombolysis. We consider whether this paradigm warrants change.

KEYWORDS:

Stroke

PMID:
26758911
DOI:
10.1136/neurintsurg-2015-012231
[Indexed for MEDLINE]

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