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

J 2023

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 et. al.

Basic information

Original name

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

Authors

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 Czech Republic, belonging to the institution), Robert MIKULÍK (203 Czech Republic, belonging to the institution), 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 and Gustavo SAPOSNIK

Edition

Stroke: Vascular and Interventional Neurology, United Hoboken, Wiley, 2023, 2694-5746

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

RIV identification code

RIV/00216224:14110/23:00133694

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1161/SVIN.122.000595

UT WoS

001157345000021

Keywords in English

endovascular therapy; large vessel occlusion; late window; mechanical thrombectomy

Abstract

V originále

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.

Citovat

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 and 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, vol. 3, No 1, p. 1-15. ISSN 2694-5746. Available from: https://dx.doi.org/10.1161/SVIN.122.000595.

@article{2379840,
   author = {Nguyen, Thanh N and Klein, Piers and Berberich, Anne and Nagel, Simon and Abdalkader, Mohamad and Herning, Ana and Chen, Yimin and Huo, Xiaochuan and Miao, Zhongrong and Sheth, Sunil A and Qureshi, Muhammad M and Siegler, James E and Sacco, Simona and Strbian, Daniel and Fischer, Urs and Yamagami, Hiroshi and Kristoffersen, Espen Saxhaug and Puetz, Volker and Schonewille, Wouter and Tsivgoulis, Georgios and Drumm, Brian and Banerjee, Soma and Demeestere, Jelle and Alemseged, Fana and Sandset, Else C and Arsovska, Anita Ante and Krishnan, Kailash and Dhillon, Permesh S and Corredor, Angel and Rivera, Rodrigo and Šedová, Petra and Mikulík, Robert and Masoud, Hesham E and Martins, Sheila O and Nguyen, Thang Huy and Ton, Mai Duy and Liu, Xinfeng and Zhu, Yuyou and Li, Fengli and Zaidi, Wan Asyraf Wan and Zedde, Marialuisa and Yaghi, Shadi and Miao, Jian and Inoa, Violiza and Zhang, Liqun and Masiliunas, Rytis and Slade, Peter and Matuja, Sarah Shali and Marto, Joao Pedro and Michel, Patrik and Fiehler, Jens and Thomalla, Gotz and Castonguay, Alicia C and Mokin, Maxim and Parsons, Mark and Campbell, Bruce C V and Yavagal, Dileep R and Dippel, Diederik and Goyal, Mayank and Zaidat, Osama O and Jovin, Tudor G and Hu, Wei and Nogueira, Raul G and Qiu, Zhongming and Raymond, Jean and Saposnik, Gustavo},
   article_location = {United Hoboken},
   article_number = {1},
   doi = {http://dx.doi.org/10.1161/SVIN.122.000595},
   keywords = {endovascular therapy; large vessel occlusion; late window; mechanical thrombectomy},
   language = {eng},
   issn = {2694-5746},
   journal = {Stroke: Vascular and Interventional Neurology},
   title = {Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey},
   url = {https://www.ahajournals.org/doi/10.1161/SVIN.122.000595},
   volume = {3},
   year = {2023}
}

TY  - JOUR
ID  - 2379840
AU  - Nguyen, Thanh N - Klein, Piers - Berberich, Anne - Nagel, Simon - Abdalkader, Mohamad - Herning, Ana - Chen, Yimin - Huo, Xiaochuan - Miao, Zhongrong - Sheth, Sunil A - Qureshi, Muhammad M - Siegler, James E - Sacco, Simona - Strbian, Daniel - Fischer, Urs - Yamagami, Hiroshi - Kristoffersen, Espen Saxhaug - Puetz, Volker - Schonewille, Wouter - Tsivgoulis, Georgios - Drumm, Brian - Banerjee, Soma - Demeestere, Jelle - Alemseged, Fana - Sandset, Else C - Arsovska, Anita Ante - Krishnan, Kailash - Dhillon, Permesh S - Corredor, Angel - Rivera, Rodrigo - Šedová, Petra - Mikulík, Robert - Masoud, Hesham E - Martins, Sheila O - Nguyen, Thang Huy - Ton, Mai Duy - Liu, Xinfeng - Zhu, Yuyou - Li, Fengli - Zaidi, Wan Asyraf Wan - Zedde, Marialuisa - Yaghi, Shadi - Miao, Jian - Inoa, Violiza - Zhang, Liqun - Masiliunas, Rytis - Slade, Peter - Matuja, Sarah Shali - Marto, Joao Pedro - Michel, Patrik - Fiehler, Jens - Thomalla, Gotz - Castonguay, Alicia C - Mokin, Maxim - Parsons, Mark - Campbell, Bruce C V - Yavagal, Dileep R - Dippel, Diederik - Goyal, Mayank - Zaidat, Osama O - Jovin, Tudor G - Hu, Wei - Nogueira, Raul G - Qiu, Zhongming - Raymond, Jean - Saposnik, Gustavo
PY  - 2023
TI  - Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey
JF  - Stroke: Vascular and Interventional Neurology
VL  - 3
IS  - 1
SP  - 1-15
EP  - 1-15
PB  - Wiley
SN  - 26945746
KW  - endovascular therapy
KW  - large vessel occlusion
KW  - late window
KW  - mechanical thrombectomy
UR  - https://www.ahajournals.org/doi/10.1161/SVIN.122.000595
N2  - 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.
ER  -

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 and Gustavo SAPOSNIK. Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey. \textit{Stroke: Vascular and Interventional Neurology}. United Hoboken: Wiley, 2023, vol.~3, No~1, p.~1-15. ISSN~2694-5746. Available from: https://dx.doi.org/10.1161/SVIN.122.000595.

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