Blocking and Tackling - The Fundamentals of Stroke CT Interpretation

May 19, 2021
Non-contrast head CT remains the initial imaging modality in the workup of a patient with a suspected stroke, yet not everyone is comfortable with real time interpretation.
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Challenges in Endovascular Therapy for Acute Stroke- What Should the Rest of Us Know?

May 11, 2021
Endovascular treatment of acute stroke is intimidating to many providers. Dr. Grossman takes this opportunity to share his expertise and help the rest of us understand what neurointervention can do for acute stroke patients and what the future of endovascular stroke care holds.
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Difficult Strokes to Identify: Tricks and Tips From the Frontline

April 26, 2021
Identifying difficult stroke syndromes with Dr. Stacie Demel- learn from one of our nation's experts in stroke education and care as she takes us through the stroke syndromes that keep her up at night. The posterior circulation, the young patient, and the potential mimics that confuse us all are the focus of this podcast.
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The New Standards for Prehospital Stroke Patient Destinations; the Dawn of a New Era in EMS

March 11, 2021
The destination for prehospital patients with suspected stroke has been controversial for many years. Should they be taken to the closest ED, the closest stroke ready hospital, or the closest comprehensive stroke center? Does rural, suburban, or urban location matter when selecting a receiving institution? The new AHA white paper addresses this and more.
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IV tPA for Acute Strokes in Patients with COVID - What Does the Limited Evidence Mean?

December 4, 2020
The incidence of acute stroke in COVID-19 patients occurs at a rate that is at least 7 times greater than the general population. Controversy about the safety and efficacy of IV-tPA remains.
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Sep 7

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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