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

NGUYEN, Thanh N, Piers KLEIN, Anne BERBERICH, Simon NAGEL, Mohamad ABDALKADER, Ana HERNING, Yimin CHEN, Xiaochuan HUO, Zhongrong MIAO, Sunil A SHETH, Muhammad M QURESHI, James E SIEGLER, Simona SACCO, Daniel STRBIAN, Urs FISCHER, Hiroshi YAMAGAMI, Espen Saxhaug KRISTOFFERSEN, Volker PUETZ, Wouter SCHONEWILLE, Georgios TSIVGOULIS, Brian DRUMM, Soma BANERJEE, Jelle DEMEESTERE, Fana ALEMSEGED, Else C SANDSET, Anita Ante ARSOVSKA, Kailash KRISHNAN, Permesh S DHILLON, Angel CORREDOR, Rodrigo RIVERA, Petra ŠEDOVÁ, Robert MIKULÍK, Hesham E MASOUD, Sheila O MARTINS, Thang Huy NGUYEN, Mai Duy TON, Xinfeng LIU, Yuyou ZHU, Fengli LI, Wan Asyraf Wan ZAIDI, Marialuisa ZEDDE, Shadi YAGHI, Jian MIAO, Violiza INOA, Liqun ZHANG, Rytis MASILIUNAS, Peter SLADE, Sarah Shali MATUJA, Joao Pedro MARTO, Patrik MICHEL, Jens FIEHLER, Gotz THOMALLA, Alicia C CASTONGUAY, Maxim MOKIN, Mark PARSONS, Bruce C V CAMPBELL, Dileep R YAVAGAL, Diederik DIPPEL, Mayank GOYAL, Osama O ZAIDAT, Tudor G JOVIN, Wei HU, Raul G NOGUEIRA, Zhongming QIU, Jean RAYMOND a Gustavo SAPOSNIK. Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey. Stroke: Vascular and Interventional Neurology. United Hoboken: Wiley, 2023, roč. 3, č. 1, s. 1-15. ISSN 2694-5746. Dostupné z: https://dx.doi.org/10.1161/SVIN.122.000595.

Základní údaje

• Originální název: Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey
• Autoři: NGUYEN, Thanh N, Piers KLEIN, Anne BERBERICH, Simon NAGEL, Mohamad ABDALKADER, Ana HERNING, Yimin CHEN, Xiaochuan HUO, Zhongrong MIAO, Sunil A SHETH, Muhammad M QURESHI, James E SIEGLER, Simona SACCO, Daniel STRBIAN, Urs FISCHER, Hiroshi YAMAGAMI, Espen Saxhaug KRISTOFFERSEN, Volker PUETZ, Wouter SCHONEWILLE, Georgios TSIVGOULIS, Brian DRUMM, Soma BANERJEE, Jelle DEMEESTERE, Fana ALEMSEGED, Else C SANDSET, Anita Ante ARSOVSKA, Kailash KRISHNAN, Permesh S DHILLON, Angel CORREDOR, Rodrigo RIVERA, Petra ŠEDOVÁ (203 Česká republika, domácí), Robert MIKULÍK (203 Česká republika, domácí), Hesham E MASOUD, Sheila O MARTINS, Thang Huy NGUYEN, Mai Duy TON, Xinfeng LIU, Yuyou ZHU, Fengli LI, Wan Asyraf Wan ZAIDI, Marialuisa ZEDDE, Shadi YAGHI, Jian MIAO, Violiza INOA, Liqun ZHANG, Rytis MASILIUNAS, Peter SLADE, Sarah Shali MATUJA, Joao Pedro MARTO, Patrik MICHEL, Jens FIEHLER, Gotz THOMALLA, Alicia C CASTONGUAY, Maxim MOKIN, Mark PARSONS, Bruce C V CAMPBELL, Dileep R YAVAGAL, Diederik DIPPEL, Mayank GOYAL, Osama O ZAIDAT, Tudor G JOVIN, Wei HU, Raul G NOGUEIRA, Zhongming QIU, Jean RAYMOND a Gustavo SAPOSNIK.
• Vydání: Stroke: Vascular and Interventional Neurology, United Hoboken, Wiley, 2023, 2694-5746.

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Článek v odborném periodiku
• Obor: 30210 Clinical neurology
• Stát vydavatele: Spojené státy
• Utajení: není předmětem státního či obchodního tajemství
• WWW: URL
• Kód RIV: RIV/00216224:14110/23:00133694
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.1161/SVIN.122.000595
• UT WoS: 001157345000021
• Klíčová slova anglicky: endovascular therapy; large vessel occlusion; late window; mechanical thrombectomy
• Štítky: 14110127, 14110211, rivok
• Příznaky: Mezinárodní význam, Recenzováno

Anotace

Background Current 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. Methods We 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. Results There 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<0.0001), and high- versus low-middle income countries (70.5% versus 44.5%; P<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. Conclusion Current 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.