Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F23%3A00077955" target="_blank" >RIV/00159816:_____/23:00077955 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/23:00133694 RIV/65269705:_____/23:00077955

Result on the web

<a href="https://www.ahajournals.org/doi/epub/10.1161/SVIN.122.000595" target="_blank" >https://www.ahajournals.org/doi/epub/10.1161/SVIN.122.000595</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1161/SVIN.122.000595" target="_blank" >10.1161/SVIN.122.000595</a>

Result language

angličtina

Original language name

Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey

Original language description

BackgroundCurrent stroke guidelines recommend advanced imaging (computed tomography [CT] perfusion or magnetic resonance imaging) prior to endovascular therapy (EVT) in patients with late presentation of large vessel occlusion. Adherence to guidelines may be constrained by resources or timely access to imaging. We sought to understand the factors which influence late window imaging selection for EVT candidates with large vessel occlusion.MethodsWe conducted an international survey from January to May 2022. The questions aimed to identify advanced imaging and treatment decisions based on access to imaging, time delays, and simulated patient scenarios.ResultsThere were 3000 invited participants and 1506 respondents, the majority (89.6%) from comprehensive stroke centers in high-income countries. Neurointerventionalists comprised 31.8% and noninterventionalists 68.2% of respondents. Overall, 70.7% reported routine use of advanced imaging for late EVT selection, and 63.6% reported its usage in every case. There was greater availability of advanced imaging in comprehensive stroke centers versus primary stroke centers (67.0% versus 33.7%; P&lt;0.0001), and high- versus low-middle income countries (70.5% versus 44.5%; P&lt;0.0001). When presented with a late window patient, 41.6% would complete CT perfusion or magnetic resonance imaging prior to EVT, 25.4% would perform CT perfusion or magnetic resonance imaging prior to IVT and EVT, and 25.8% would refer to EVT without advanced imaging. If advanced imaging was not readily available, 70.1% would refer a patient to EVT based on CT in the late window. Additional time delay within 20 minutes to obtain advanced imaging was considered acceptable in 77.7% of respondents.ConclusionCurrent guidelines for imaging late window EVT candidates are inconsistent with imaging decisions by physicians. Most respondents consider an imaging delay of greater than 20 minutes unacceptable. Access to advanced imaging was greater in comprehensive stroke centers and high-income countries. In the case of limited access most respondents would consider EVT based on CT only.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Stroke-Vascular and Interventional Neurology

ISSN

2694-5746

e-ISSN

2694-5746

Volume of the periodical

3

Issue of the periodical within the volume

1

Country of publishing house

US - UNITED STATES

Number of pages

15

Pages from-to

"e000595"

UT code for WoS article

001157345000021

EID of the result in the Scopus database

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