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Updated: Jun 28, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Does study enrollment delay treatment with intravenous thrombolytics for acute ischemic stroke?
Sheryl Martin-Schild1, Karen C Albright, Hen Hallevi
1Department of Neurology, University of Texas Medical SchoolHouston Medical School, Houston, Texas 77030, USA.
Stroke
|October 25, 2008
Summary
Enrollment in acute stroke clinical trials may delay treatment. Pre-thrombolytic randomization in stroke studies significantly increased arrival-to-treatment times by 13 minutes, impacting acute ischemic stroke care.
Area of Science:
- Neurology
- Clinical Trials
- Emergency Medicine
Background:
- Acute ischemic stroke requires rapid treatment.
- Stroke centers often have multiple clinical trials.
- Trial enrollment may affect treatment timeliness.
Purpose of the Study:
- To assess if enrollment in acute stroke trials delays intravenous thrombolytic initiation.
- To compare treatment times for patients in clinical trials versus standard care.
Main Methods:
- Retrospective analysis of 290 acute ischemic stroke patients treated within 3 hours.
- Comparison of arrival-to-treatment times for patients in pre-lytic, post-lytic, and standard care groups.
- Collection of demographic, clinical severity (NIHSS), and CT data.
Main Results:
- No significant differences in patient demographics or baseline characteristics between groups.
- Pre-lytic randomization in trials significantly increased arrival-to-treatment time by 13 minutes (P=0.028).
- No difference in arrival-to-treatment times for post-lytic or overall trial enrollment compared to standard care.
Conclusions:
- Trials requiring pre-thrombolytic randomization can delay treatment initiation for acute stroke patients.
- Further research is needed to quantify clinical significance and optimize enrollment strategies.
- Improving trial design may mitigate delays in time-sensitive stroke interventions.
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