Log in with your email address username.


Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

Clot retrieval and acute stroke care

- Featured Image

Resource distribution in stroke care must be rational and evidence-based, not driven by media coverage

There has been a sudden upsurge of interest in the availability of endovascular clot retrieval (ECR) for stroke treatment (Box). Recent newspaper articles published in New South Wales1,2 highlight the potential benefits as well as the financial and logistical challenges of providing around the clock ECR services in a vast country like Australia.

Many well designed randomised trials have demonstrated the efficacy and safety of ECR,3 but the evidence of benefit, although dramatic in some cases, is confined to patients whose ECR procedure begins within 6 hours of symptom onset,4 with or without intravenous thrombolysis. However, before 24/7 ECR services can operate in Australia, individual health services need to examine the challenges of transporting eligible stroke patients from the emergency departments wherever they may be — remote, regional or urban — to a comprehensive stroke centre within the required time window. This potentially means covering vast distances — several hundreds of kilometres in some cases — in a matter of hours. A detailed analysis then needs to demonstrate that the benefits of a rapid ECR service…