On 2014 Sep 30, Ryan Radecki commented:

Post-publication commentary:

"For tPA, Is Delusion the Standard of Care?"

Yet again, the tPA apologists dip into their bag of registry data in an attempt to defend tPA – and end up contradicting themselves.

In 2009, neurologists in India published a retrospective case series examining the outcomes following tPA at their institution. Specifically, they divided up the cases between those with arterial occlusion present on CT angiogram of the cerebral vessels, and those with no demonstrated arterial occlusion. For patients with demonstrated occlusion, there were significant differences in early NIHSS improvement favoring tPA, but no long term mRS improvements. Conversely, there were 119 without occlusion present – and the early NIHSS improvement and late mRS improvement outcomes were similar. There were, however, substantial baseline differences between those receiving tPA and those who did not – and retrospective studies are confounded by many biases – but there was at least a suggestion that some stroke subtypes might not benefit from tPA....

http://www.emlitofnote.com/2014/09/for-tpa-is-delusion-standard-of-care.html

On 2014 Sep 30, Ryan Radecki commented:

Post-publication commentary:

"For tPA, Is Delusion the Standard of Care?"

Yet again, the tPA apologists dip into their bag of registry data in an attempt to defend tPA – and end up contradicting themselves.

In 2009, neurologists in India published a retrospective case series examining the outcomes following tPA at their institution. Specifically, they divided up the cases between those with arterial occlusion present on CT angiogram of the cerebral vessels, and those with no demonstrated arterial occlusion. For patients with demonstrated occlusion, there were significant differences in early NIHSS improvement favoring tPA, but no long term mRS improvements. Conversely, there were 119 without occlusion present – and the early NIHSS improvement and late mRS improvement outcomes were similar. There were, however, substantial baseline differences between those receiving tPA and those who did not – and retrospective studies are confounded by many biases – but there was at least a suggestion that some stroke subtypes might not benefit from tPA....

http://www.emlitofnote.com/2014/09/for-tpa-is-delusion-standard-of-care.html