Optimizing Stroke Care for Patients with Large Vessel Occlusions: Current State of the Art and Future Directions

J Neuroendovasc Ther. 2020;14(6):203-214. doi: 10.5797/jnet.ra.2020-0024. Epub 2020 Mar 27.

Abstract

Acute ischemic stroke (AIS) is a severely disabling disease. Endovascular therapy is a powerful and highly effective treatment option for these patients and has recently become standard of care. The benefits of endovascular treatment (EVT) are tremendous both from a patient and from an economic perspective, since it dramatically improves individual patient outcomes while reducing long-term healthcare costs at the same time. The effect of EVT is highly time-dependent. Thus, the overarching goal in AIS is to quickly transport and diagnose the patient to minimize treatment delays. In this review, we provide an overview about the current state of stroke care, propose a fast and simplified imaging protocol and management approach for AIS patients. We also highlight the challenges we are currently facing in endovascular stroke treatment and suggest possible solutions to overcome these.

Keywords: acute ischemic stroke; endovascular therapy; mechanical thrombectomy; multiphase CT angiography; stroke imaging.

Publication types

  • Review