Critical Care Scenarios Episode 89: Thrombectomy for stroke, with Justin Fraser
May 14, 2025
Justin Fraser, a leading expert in cerebrovascular and neuro-interventional surgery, delves into the revolutionary thrombectomy procedure for treating acute ischemic strokes. He shares insights on advancements in technology and patient transfer protocols that optimize outcomes. The discussion also highlights innovative treatments like tenecteplase, the evolution of multidisciplinary collaboration in neurointerventional surgery, and the ethical challenges faced in acute care. Fraser's expertise showcases how evolving practices are reshaping patient care in this critical field.
AI Snips
Chapters
Transcript
Episode notes
Thrombectomy Standard of Care
- Thrombectomy is now the accepted standard for treating large vessel occlusion strokes whenever possible.
- Rapid imaging review and streamlined transfers significantly improve patient outcomes in stroke care.
Mandatory Transfer for Eligible Patients
- You must transfer patients eligible for thrombectomy to capable centers without delay.
- Keeping large vessel occlusion stroke patients at non-thrombectomy centers is a major deviation from practice.
Thrombectomy's Strong Evidence Base
- Thrombectomy's effectiveness surpasses many interventions with an estimated number needed to treat around 2.
- Initial skepticism from early trials was overturned by subsequent studies confirming strong benefits.