(Part 21) Antiplatelet treatment compared with anticoagulation treatment for CADISS скачать в хорошем качестве

(Part 21) Antiplatelet treatment compared with anticoagulation treatment for CADISS

🧬 The trial that changed cervical artery dissection treatment forever 🧬 For decades, stroke physicians debated: anticoagulation or antiplatelets for cervical artery dissection? The CADISS trial finally gave us evidence-based answers in this challenging clinical scenario. The Clinical Dilemma: Cervical artery dissection is a leading cause of stroke in young adults (less than 50 years). Traditional teaching favored anticoagulation due to assumed high embolic risk from fibrin-rich thrombus, but this was based on dogma, not data. Risk of recurrent stroke was thought to be dangerously high. What They Did: ✅ First-ever RCT in cervical dissection (250 patients) ✅ 39 UK centers + 7 Australian centers ✅ Carotid and vertebral dissections within 7 days of onset ✅ Randomized to antiplatelet vs anticoagulation therapy for 3 months ✅ Primary outcome: recurrent stroke at 3 months Game-Changing Results: 🎯 Ultra-low recurrent stroke rate: Only 4 strokes total (2% of patients) 🎯 3 strokes in antiplatelet group vs 1 in anticoagulation group 🎯 1 major hemorrhage in anticoagulation group vs 0 in antiplatelet group 🎯 NO significant difference between treatment groups 🎯 Both strategies much safer than historically believed Why This Matters: CADISS revolutionized practice by showing that recurrent stroke risk in cervical dissection is much lower than feared. It established equipoise between treatments and paved the way for antiplatelet therapy as first-line treatment - safer, cheaper, and more convenient than anticoagulation. Clinical Pearl: The trial was designed as a feasibility study but answered the key clinical question: both treatments are reasonable, recurrent stroke is rare, and we can safely use antiplatelets in most cases. How has this changed your practice? Do you still reach for anticoagulation first in young stroke patients with dissection? 🤔 👆 Follow for more practice-changing trials | Share with your stroke team | Visit NowyouknowNeuro.com for the complete analysis #Neurology #CervicalDissection #Stroke #CADISS #AnticoagulationVsAntiplatelets [Links] Original Article: NowYouKnow Neuro: https://www.nowyouknowneuro.com/ Blog: https://www.nowyouknowneuro.com/antip... Subscribe: https://www.nowyouknowneuro.com/sign-... Instagram: NowyouknowNeuro