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ESC Heart & Brain Workshop IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and Medtronic in the form of educational grants. The scientific programme has not been influenced in any way by its sponsors. Natan Bornstein & Marta Rubiera Stroke Neurologists

Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

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Page 1: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

ESC Heart & Brain Workshop

IV Thrombolysis

Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and Medtronic in the form of educational grants. The scientific programme has not been influenced in any way by its sponsors.

Natan Bornstein & Marta RubieraStroke Neurologists

Page 2: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

57 years-old female, hypertensive, who presents withsomnolence, deep right hemiplegia and severe aphasia…

WHEN ? Witnessed, 2.5 hours ago…

WHAT ? RACE 8 TACI

WHY NOT?

Strokeneurologist

EMS

Page 3: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

Probability of Large Vessel Occlusion

TRIAGE

Page 4: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

57 years-old female, hypertensive, who presents withsomnolence, deep right hemiplegia and severe aphasia…

WHEN ? Witnessed, 2.5 hours ago…

WHAT ? RACE 9 TACI

WHY NOT? No contraindications BP 160/98 Glc 122

Coagulation / platelets ??

Strokeneurologist

EMS

Coagulation /platelets ??

Page 5: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 6: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

Emergency Room

CT-Scan

Angio-Suite

Pre-notificationRACE>4 o NIHSS >10< 6 hours

ER CODE

CT CODE

ANGIO CODE

Page 7: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 8: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 9: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 10: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 11: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

24h NIHSS: 2

Page 12: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

WHEN ? Last seen normal 12h ago, when he went to bed

WHAT ? RACE 6 TACI

WHY NOT?

Comarcal neurologist

83 years-old male, mRS 2, DM, HTA, who is found at bedwith dysarthria and moderate left hemiparesia and heminegligency…

Last seen normal 12h ago !!

EMS

Page 13: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 14: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

?

Page 15: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and

J.strokecerebrovascdis. 2016, 25; 11:2063-69

Page 16: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and
Page 17: Thrombolysis - European Society of Cardiology · IV Thrombolysis Supported by Bayer, Bristol-Myers Squibb and Pfizer Alliance, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH and