Stroke protocols per AAN meetings

Candidate selection for intervention level 2 evidence

 

1) Patients  inelegible for iv tPA within 6 hours use lytics, within 8 hours, MERCI

2) Consider longer duration for posterior circulation disease

3)  Use of DWI'PWI mismatch for patients beyond standard time windows.

 

Within 3 hours patients with ICA, MCA, BA occlusion, patients that fail to respond to IV tPA, or are excluded by NINDS iv exclusion criteria are candidates for intervention

 

3-6 hours patients with DWI/PWI mismatch are candidates for arterial

 

6-8 hours MERCI candidates

>8 hours for posterior circulation

 

Intervention

10 % vessels are open

first use 22-25 mg tPA inside clot

then go to stenting if reperfuse great

 

if don't reperfuse go to clot retrieval.

 

 

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