For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
3
views
67
references
 Top references
cited by
6
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      514
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Large Vessel Occlusion Stroke Detection in the Prehospital Environment

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose of Review

          Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients.

          Recent Findings

          Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients.

          Summary

          The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway.

          Related collections

          Most cited references67

          • Record: found
          • Abstract: found
          • Article: not found

          Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct

          Tudor G Jovin, Raul Nogueira, Ashutosh Jadhav … (2018)
          The 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.
          Article 0 comments Cited 1069 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging

            Gregory W Albers, Michael Marks, Stephanie Kemp … (2018)
            New England Journal of Medicine, 378(8), 708-718
            Article 0 comments Cited 960 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke

              Mayank Goyal, Andrew M Demchuk, Bijoy K. Menon … (2015)
              Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of patients die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. We evaluated rapid endovascular treatment in addition to standard care in patients with acute ischemic stroke with a small infarct core, a proximal intracranial arterial occlusion, and moderate-to-good collateral circulation. We randomly assigned participants to receive standard care (control group) or standard care plus endovascular treatment with the use of available thrombectomy devices (intervention group). Patients with a proximal intracranial occlusion in the anterior circulation were included up to 12 hours after symptom onset. Patients with a large infarct core or poor collateral circulation on computed tomography (CT) and CT angiography were excluded. Workflow times were measured against predetermined targets. The primary outcome was the score on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) at 90 days. A proportional odds model was used to calculate the common odds ratio as a measure of the likelihood that the intervention would lead to lower scores on the modified Rankin scale than would control care (shift analysis). The trial was stopped early because of efficacy. At 22 centers worldwide, 316 participants were enrolled, of whom 238 received intravenous alteplase (120 in the intervention group and 118 in the control group). In the intervention group, the median time from study CT of the head to first reperfusion was 84 minutes. The rate of functional independence (90-day modified Rankin score of 0 to 2) was increased with the intervention (53.0%, vs. 29.3% in the control group; P<0.001). The primary outcome favored the intervention (common odds ratio, 2.6; 95% confidence interval, 1.7 to 3.8; P<0.001), and the intervention was associated with reduced mortality (10.4%, vs. 19.0% in the control group; P=0.04). Symptomatic intracerebral hemorrhage occurred in 3.6% of participants in intervention group and 2.7% of participants in control group (P=0.75). Among patients with acute ischemic stroke with a proximal vessel occlusion, a small infarct core, and moderate-to-good collateral circulation, rapid endovascular treatment improved functional outcomes and reduced mortality. (Funded by Covidien and others; ESCAPE ClinicalTrials.gov number, NCT01778335.).
              Article 0 comments Cited 862 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-journal-id): 101604815
                Journal ID (pubmed-jr-id): 41192
                Journal ID (nlm-ta): Curr Emerg Hosp Med Rep
                Journal ID (iso-abbrev): Curr Emerg Hosp Med Rep
                Title: Current emergency and hospital medicine reports
                ISSN (Electronic): 2167-4884
                Publication date Nihms-submitted: 28 September 2022
                Publication date (Print): September 2021
                Publication date (Electronic): 28 June 2021
                Publication date PMC-release: 05 October 2022
                Volume: 9
                Issue: 3
                Pages: 64-72
                Affiliations
                [1 ]University of California San Francisco, 505 Parnassus Ave, S784, San Francisco, CA 94122, USA
                [2 ]University of California Davis, Davis, USA
                Author notes
                Author information
                http://orcid.org/0000-0002-2406-3298
                Article
                Manuscript ID: NIHMS1836888
                DOI: 10.1007/s40138-021-00234-9
                PMC ID: 9534324
                PubMed ID: 36204242
                SO-VID: 12823ac3-9cb7-481e-b4d6-344fdbf2de62
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Categories
                Subject: Article

                Keywords: large vessel occlusion,prehospital stroke triage,acute ischemic stroke,stroke scale,medical devices for stroke detection,mobile stroke units,lvo device
                Data availability:
                Keywords: large vessel occlusion, prehospital stroke triage, acute ischemic stroke, stroke scale, medical devices for stroke detection, mobile stroke units, lvo device

                Comments

                Comment on this article

                scite_

                Similar content514

                See all similar

                Cited by6

                See all cited by

                Most referenced authors1,137

                See all reference authors