Endovascular therapy for anterior circulation large vessel occlusion in telestroke.

Published on Apr 1, 2021in Journal of Telemedicine and Telecare2.616
· DOI :10.1177/1357633X19867193
Haidar Moustafa4
Estimated H-index: 4
(TUD: Dresden University of Technology),
Kristian Barlinn21
Estimated H-index: 21
(TUD: Dresden University of Technology)
+ 10 AuthorsJessica Barlinn7
Estimated H-index: 7
(TUD: Dresden University of Technology)
IntroductionRecent exploratory analysis suggested comparable outcomes among stroke patients undergoing endovascular therapy (EVT) for anterior circulation large vessel occlusion, whether selected v...
#1Gordian J. HubertH-Index: 7
#2Gustavo C Santo (UC: University of Coimbra)H-Index: 8
Last. Francesco CoreaH-Index: 24
view all 8 authors...
Lack of stroke specialists determines that many European rural areas remain underserved. Use of telemedicine in stroke care has shown to be safe, increase use of evidence-based therapy and enable c...
20 CitationsSource
#1Raphaël Le Bouc (University of Paris)H-Index: 4
#2Frédéric Clarençon (University of Paris)H-Index: 23
Last. Yves Samson (University of Paris)H-Index: 72
view all 22 authors...
Background and Purpose— Efficacy of endovascular treatment (EVT) for ischemic stroke because of large vessel occlusion may depend on patients’ age and stroke severity; we, therefore, developed a pr...
9 CitationsSource
#1Ashutosh P Jadhav (University of Pittsburgh)H-Index: 30
#2Shashvat M Desai (University of Pittsburgh)H-Index: 12
Last. Tudor G Jovin (University of Pittsburgh)H-Index: 70
view all 9 authors...
Background and Purpose— The results of the DAWN trial (Diffusion-Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo) support the benefit of endovascular therapy in patients presenting beyond the 6-hour time window with anterior circulation large vessel occlusions. The impact of these results with respect to additional number of eligible patients in clinical practice r...
76 CitationsSource
#1Gregory W. Albers (SC: University of Southern California)H-Index: 122
#2Michael P. Marks (SC: University of Southern California)H-Index: 82
Last. Maarten G Lansberg (U of C: University of Calgary)H-Index: 60
view all 26 authors...
Abstract Background Thrombectomy is currently recommended for eligible patients with stroke who are treated within 6 hours after the onset of symptoms. Methods We conducted a multicenter, randomized, open-label trial, with blinded outcome assessment, of thrombectomy in patients 6 to 16 hours after they were last known to be well and who had remaining ischemic brain tissue that was not yet infarcted. Patients with proximal middle-cerebral-artery or internal-carotid-artery occlusion, an initial in...
1,859 CitationsSource
#1Raul G Nogueira (Emory University)H-Index: 62
#2Ashutosh P Jadhav (University of Pittsburgh)H-Index: 30
Last. Tudor G Jovin (University of Pittsburgh)H-Index: 70
view all 47 authors...
BackgroundThe effect of endovascular thrombectomy that is performed more than 6 hours after the onset of ischemic stroke is uncertain. Patients with a clinical deficit that is disproportionately severe relative to the infarct volume may benefit from late thrombectomy. MethodsWe enrolled patients with occlusion of the intracranial internal carotid artery or proximal middle cerebral artery who had last been known to be well 6 to 24 hours earlier and who had a mismatch between the severity of the c...
2,191 CitationsSource
#1Jessica BarlinnH-Index: 7
#2Johannes GerberH-Index: 31
Last. Ulf BodechtelH-Index: 16
view all 12 authors...
BackgroundFive randomized controlled trials recently demonstrated efficacy of endovascular treatment in acute ischemic stroke. Telestroke networks can improve stroke care in rural areas but their r...
32 CitationsSource
#1Maxim Mokin (USF: University of South Florida)H-Index: 30
#2Rishi GuptaH-Index: 52
Last. Sananthan Sivakanthan (USF: University of South Florida)H-Index: 7
view all 6 authors...
Background Favorable imaging profile according to the Alberta Stroke Program Early CT Score (ASPECTS) on non-contrast head CT is a key criterion for the selection of patients with ischemic stroke from large vessel occlusion (LVO) for IA revascularization therapies. Objective To analyze factors associated with changes in ASPECTS during inter-hospital transfer and to determine how deterioration of ASPECTS affects eligibility for endovascular procedures. Methods We analyzed factors associated with ...
42 CitationsSource
#1Jan F. Scheitz (German Center for Neurodegenerative Diseases)H-Index: 23
#2Azmil H. Abdul-Rahim (Glas.: University of Glasgow)H-Index: 17
Last. Kennedy R. LeesH-Index: 99
view all 14 authors...
Background and Purpose—The National Institutes of Health Stroke Scale (NIHSS) correlates with presence of large anterior vessel occlusion (LAVO). However, the application of the full NIHSS in the p...
76 CitationsSource
#1Peter VanackerH-Index: 15
#2Dimitris LambrouH-Index: 9
Last. Patrik MichelH-Index: 58
view all 6 authors...
Background and Purpose— Endovascular treatment (EVT) is a new standard of care for selected, large vessel occlusive strokes. We aimed to determine frequency of potentially eligible patients for intravenous thrombolysis (IVT) and EVT in comprehensive stroke centers. In addition, predictors of EVT eligibility were derived. Methods— Patients from a stroke center–based registry (2003–2014), admitted within 24 hours of last proof of usual health, were selected if they had all data to determine IVT an...
41 CitationsSource
Background and Purpose— Since demonstration of the benefit of endovascular treatment (EVT) in acute ischemic stroke patients with proximal arterial occlusion, stroke care systems need to be reorganized to deliver EVT in a timely and equitable way. We analyzed differences in the access to EVT by geographical areas in Catalonia, a territory with a highly decentralized stroke model. Methods— We studied 965 patients treated with EVT from a prospective multicenter population-based registry of stroke ...
28 CitationsSource
Cited By6
#1Sigrid MuesH-Index: 1
#2Wenke GrönheitH-Index: 9
Last. Jörg WellmerH-Index: 27
view all 4 authors...
1 CitationsSource
#1Isobel E.R. MacKenzie (GW: George Washington University)H-Index: 1
#2Toomas Arusoo (GW: George Washington University)
Last. Dimitri Sigounas (GW: George Washington University)H-Index: 4
view all 3 authors...
INTRODUCTION Mechanical thrombectomy is a proven treatment for large vessel ischemic stroke with improved functional outcomes when compared to intravenous thrombolytics. Access to thrombectomy-capable sites varies greatly by geography, often necessitating interhospital transfer of patients who first present to hospitals not able to deliver thrombectomy. The purpose of this meta-analysis is to examine the impact of interhospital transportation on patient outcomes to better inform recommendations ...
#1Laura C. C. van Meenen (UvA: University of Amsterdam)H-Index: 2
#2Maritta N. van Stigt (UvA: University of Amsterdam)
Last. Jonathan M. Coutinho (UvA: University of Amsterdam)H-Index: 30
view all 12 authors...
A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinical outcomes of patients. Here, we outline our view on the requirements of an effective prehospital LVO detection method, namely: high diagnostic accura...
#1Sonu BhaskarH-Index: 13
#2Sian Bradley (UNSW: University of New South Wales)H-Index: 4
Last. Daniel RayH-Index: 15
view all 12 authors...
Technology has acted as a great enabler of patient continuity through remote consultation, ongoing monitoring, and patient education using telephone and videoconferencing in the coronavirus disease 2019 (COVID-19) era. The devastating impact of COVID-19 is bound to prevail beyond its current reign. The vulnerable sections of our community, including the elderly, those from lower socioeconomic backgrounds, those with multiple comorbidities, and immunocompromised patients, endure a relatively high...
30 CitationsSource
Introduction While telestroke allows early intravenous thrombolysis (IVT) for ischemic strokes in spoke centers, mechanical thrombectomy (MT) for large vessel occlusion (LVO) is mainly performed at comprehensive stroke centers (CSCs). We aimed to compare 3 month outcome in patients with LVO after admission to a spoke center using telestroke compared with first CSC admission in our large regional stroke network, irrespective of final treatment decision. Methods All consecutive LVO patients who we...
3 CitationsSource