Estimating Nonhemorrhagic Risks Associated with Ischemic Stroke Evaluation and Treatment

Anaphylaxis after tPA administration is rare, and underlying renal impairment should not prevent timely CT angiography.

The time-dependent nature of stroke evaluation and treatment pushes clinicians to work quickly to perform risk-benefit calculations unique to each patient. Patient and family discussions commonly focus on the both the risks of hemorrhagic conversion after tissue plasminogen activator (tPA) administration and failure to improve if conservative management is chosen. Another potential side effect, postthrombolytic lingual angioedema, occurs in roughly 1 of 45 patients. Two recent papers in Stroke quantify additional risks: contrast-associated nephropathy in patients undergoing endovascular therapy (EVT) and anaphylaxis after tPA administration.

In one study, researchers reviewed records for 336 consecutive patients undergoing EVT at a single ce…

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)