Different Strokes: Addressing Real Clinician Questions and Controversies Surrounding Acute Management of Ischemic Stroke (Credit Expired)


Acute ischemic stroke (AIS) is one of the leading causes of death and disability in the US. As a provider’s quick thinking and rapid actions are critical to patient outcomes, it is essential that clinicians are proficient and coordinated in optimized approaches to its management. But despite this need for cohesion, several elements of stroke work-up and treatment lack clear consensus and strategies are easily disrupted by challenges with clinic flow and variations in access/expertise. With institutions rethinking their choice of intravenous thrombolytic (IVT) (e.g., with novel tenecteplase) for the first time in decades and the view of classic strategies (e.g., mechanical thrombectomy) shifting, it is more important than ever to be up to date. In this activity, Drs Panagos, Albers, and Zachrison use real clinician questions to address the most prevalent challenges in the evolving world of stroke management and provide evidence-based insight into maximizing AIS care today.

Target Audience

This activity is intended for emergency medicine clinicians, general neurologists, nurse practitioners, physician assistants, and other healthcare professionals involved in the care of patients with ischemic stroke.

Learning Objectives

Upon completion of the educational activity, participants should be able to:

  • Review the variable diagnostic considerations (e.g., imaging requirements, vague symptoms, assessment scales) and emerging strategies (e.g., IVT in wake-up stroke) for different pathologies of AIS to determine how they can be effectively optimized to maximize timely recognition and subsequent therapeutic initiation
  • Distinguish the rationale for, clinical profiles of, and phase 3 data with current and emerging IV thrombolytics to determine how and for whom each of these agents should be utilized in the treatment of AIS
  • Review published data surrounding the optimal use and timing of mechanical thrombectomy (alone or in combination with IVT) to better customize therapeutic decision-making and optimize patient outcomes for individuals with different presentations of stroke
Course summary
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Peter D. Panagos, MD, FACEP, FAHA (Chair and Moderator)
Professor of Emergency Medicine
Vice Chair, Academic and Faculty Affairs in Emergency Medicine
Chief, Neurosciences Division
Washington University
St. Louis, Missouri



Gregory W. Albers, MD (Panelist)
Professor of Neurology
Director, Stanford Stroke Center
Member, Wu Tsai Neurosciences Institute
Stanford University
Palo Alto, California




Kori Sauser Zachrison, MD, MSc (Panelist)
Associate Professor of Emergency Medicine
Harvard Medical School
Co-Director, Center for Neurologic Emergencies
Massachusetts General Hospital
Boston, Massachusetts


Community ER Providers

William Flores, PA
Emergency Medicine
Rush Copley Medical Center
Aurora, Illinois
Jesse Brown VA Medical Center
Chicago, Illinois

Tracy Parrish, MD
Emergency Medicine
Hospice and Palliative Medicine
Caldwell Memorial Hospital
Lenoir, North Carolina

Jeremy Strohkirch, MD
Emergency Medicine
Providence Hospital
Southfield, Michigan

Lisa Tarris, MD
Emergency Medicine
Carondelet St. Mary’s Hospital
Tucson, Arizona

Credit for this program has expired. The accreditation information below is based on the activity release date.

This activity is jointly provided by Medical Education Resources (MER) and Efficient LLC.

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Joint Accreditation Statement



In support of improving patient care, this activity has been planned and implemented by MER and Efficient, LLC. MER is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Designation Statement

MER designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Relevant Financial Relationships

MER insures balance, independence, objectivity, and scientific rigor in all our educational activities. In accordance with this policy, MER identifies relevant financial relationships with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Reported relevant financial relationships are mitigated by MER to ensure that all scientific research referred to, reported, or used in a CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing learners with high-quality CE activities that promote improvements or quality in health care and not the business interest of an ineligible company.

Planners' and Managers' Disclosure
MER planners and managers have nothing to disclose. Efficient LLC planners and managers have nothing to disclose.

Faculty Disclosures

Dr Panagos (Chair):

  • Grants/Research Support: NIH/NINDS, PI StrokeNet

Dr Albers:

  • Consulting Fees: Genentech, iSchemaView

Dr Zachrison  reported no relevant financial relationships.

Consulting Emergency Medicine Clinicians' Disclosures

Dr Parrish reported no relevant financial relationships.

Dr Tarris reported no relevant financial relationships.

Dr Strohkirch reported no relevant financial relationships.

Mr Flores reported no relevant financial relationships.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Commercial Support

This activity is supported by an educational grant from Genentech, a member of the Roche Group.


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