Pitfalls in CTP: Why CTP Isn’t Always the Holy Grail in Acute Stroke Imaging

March 8, 2022
CTP is alluring in acute stroke and continues to become more available. But it's complicated. Learn the pitfalls and traps from a true expert in perfusion imaging.
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When Should We Consider Restarting Anticoagulation in DVT, PE and Afib Patients? What Should I Tell the Family To Be on the Look-Out for Once They Are Discharged?

February 1, 2022
When patients need anticoagulation but have had an ICH or large ischemic stroke, when do we restart anticoagulation? When, if ever, is it safe?  
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What Key Lessons Have I Learned Managing Hemorrhagic Bleeding in the ICU & Critical Care?

January 25, 2022
Intracerebral hemorrhages are challenging to manage and patients need immediate interventions to preserve life and limit morbidity. Lessons learned from the ICU and ED shed light on how to best care for these patients.
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A Review of the Different Types of Anticoagulants and Their Clinical Applications

January 18, 2022
Anticoagulation in clinical practice is more common and more complicated every day. Understanding what they are, how they're used and when you'll see them in the clinical arena is critical. Two experts discuss their understanding of the landscape of anticoagulation and what you need to know about it.
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Why Is the Extended Window Controversial and What Happened With the FDA?

September 7, 2021

Ever wonder why the FDA didn't approve the extended time window for tPA after ECASS3? Listen here to understand the discussion.

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Why Is the Extended Window Controversial and What Happened With the FDA?

Haemin Go posted on 9/7/2021

Moderator: William A. Knight IV, MD, FACEP, FNCS
Other Participants: Stacie L. Demel, DO, PhD

The ECASS 3 trial was an RCT of IV-rtPA in the window of 3-4.5 hrs after onset of stroke symptoms. It was conducted in Europe. The European regulatory bodies have endorsed tPA for that window, but the FDA has not. Listen to two national experts in stroke discuss the trial and the meaning of the endorsement or lack thereof. This podcast is a must for acute stroke practitioners!

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2 comments on article "Why Is the Extended Window Controversial and What Happened With the FDA?"

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Ken Milne

I watched the video on ECASS-III and you mentioned the controversy in this time window. However, there was no mention of Alper et al reanalysis in the BMJ_EBM that questioned the results? Can you comment? https://ebm.bmj.com/content/25/5/168


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Ken Milne

Here was some of our feedback on Alper et al https://ebm.bmj.com/content/early/2020/08/10/bmjebm-2020-111517
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