New ATLAS meta-analysis (6 RCTs, N=1,886) shows real benefit for EVT: 📉 NNT ≈ 4 for less disability 🚶‍♂️ Independence: 19.5% vs 7.5% ✅ Even ASPECTS 0–2 benefit ​⚠️ The gray zone: Core ≥150 mL (esp. >6h). ​Bottom line: Expand eligibility, but counsel realistically. #Neurology #Stroke #Neuroradiology #Neurointervention #LargeCore 🔗 doi.org/10.1016/S0140-6736(2…

Mild symptoms or late arrival need not close the door to thrombectomy. Two NEJM trials highlight the value of imaging selection: 🧠 MILD-MT: NIHSS <6, ≤24 h, core ≤50 mL and mismatch ≥50 mL. EVT improved 90-day mRS 0–1: 69.4% vs 50.0% (NNT 6). Symptomatic ICH: 2.1% vs 1.9%; serious procedural complications: 13.2%. ⏱️ LATE-MT: Selected LVO patients presenting 24–72 h benefited functionally (common OR 1.74), but symptomatic ICH was 4.8% vs 0% and mortality 6.0% vs 1.8%. Assess the vessel and salvageable tissue—not NIHSS or clock alone. Selection and procedural risk matter. NEJM references: MILD-MT: doi.org/10.1056/NEJMoa260914… LATE-MT: doi.org/10.1056/NEJMoa260936… #Stroke #Thrombectomy #Neuroradiology

Before celebrating this unfunded government directive, we must first ask what it will mean for patients financially—and who will ultimately bear the cost of putting it into practice. At present, many hospitals reprocess certain devices and bill patients only for sterilisation. Requiring a new device for every procedure could replace that limited fee with the entire cost of purchasing the device, leading to a significant hike in hospital bills. The burden becomes even heavier when insurance policies exclude particular disposable items, forcing patients to pay the uncovered amount themselves. Patient safety cannot be compromised, but access to healthcare must not be compromised either. Current sterilization procedures are very, very efficient & effective. Requirement for single-use devices should be supported by affordable safety protocols, clear and transparent billing, and sufficient insurance protection. A safety measure can be considered successful only if it safeguards patients without making treatment unaffordable. First start making these expensive devices in India and then pass orders [Eg. No neuro endovascular devices like those used in treatment of stroke are currently manufactured in India] @MoHFW_INDIA @PMOIndia