A review of acute ischemic stroke triage protocol evidence: a context for discussion

Journal of Neurointerventional Surgery
Alexander G ChartrainJ Mocco

Abstract

Endovascular thrombectomy (EVT) is now the standard of care for eligible patients with acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO). However, there remains uncertainty in how hospital systems can most efficiently route patients with suspected ELVO for EVT treatment. Given the relative geographic distribution of centers with and without endovascular capabilities, the value of prehospital triage directly to centers with the ability to provide EVT remains debated. While there are no randomized trial data available to date, there is substantial evidence in the literature that may offer guidance on the subject. In this review we examine the available data in the context of improving the existing AIS triage systems and discuss how prehospital triage directly to endovascular-capable centers may confer clinical benefits for patients with suspected ELVO.

Citations

Jun 14, 2019·Journal of the American Heart Association·Ludwig SchlemmEckhard Schlemm
Jun 15, 2019·Journal of Neurointerventional Surgery·Ting-Yu LiuYu-Ching Lee
Jun 16, 2019·Journal of Neurointerventional Surgery·Juan Carlos Martinez-GutierrezThabele Leslie-Mazwi
Oct 8, 2020·Stroke; a Journal of Cerebral Circulation·Esmee VenemaDavid M Kent
Feb 18, 2021·Journal of Neurointerventional Surgery·Ron DanzigerBernard Yan
Apr 10, 2021·Journal of Neurointerventional Surgery·Kurt A YaegerJohanna T Fifi

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