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Updated: Jun 18, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Prehospital stroke care: potential, pitfalls, and future.
Mikael Mazighi1, Laurent Derex, Pierre Amarenco
1INSERM U-698, Clinical Research in Atherothrombosis and Denis Diderot University, France.
Current Opinion in Neurology
|November 21, 2009
Summary
Improving acute ischemic stroke care requires reducing delays in treatment. Strategies focus on patient and professional education, optimized transport, and leveraging telestroke expertise to increase access to tissue-type plasminogen activator.
Area of Science:
- Neurology
- Emergency Medicine
- Public Health
Background:
- Tissue-type plasminogen activator (tPA) is the sole approved pharmacological treatment for acute ischemic strokes.
- Less than 5% of eligible patients receive tPA due to significant prehospital and in-hospital delays.
- Limited stroke center coverage further exacerbates access issues.
Purpose of the Study:
- To identify factors limiting rapid access to acute stroke care.
- To explore strategies for reducing prehospital delays and improving tPA administration.
- To discuss future developments in acute stroke management.
Main Methods:
- Review of factors influencing time from stroke onset to hospital admission.
- Analysis of current strategies to reduce prehospital delays.
- Discussion of emerging technologies and therapeutic interventions.
Main Results:
- Prehospital and in-hospital delays are critical barriers to tPA treatment.
- Patient and healthcare provider education is essential for reducing delays.
- Optimizing emergency medical services transport protocols can improve access.
Conclusions:
- Shortening prehospital delays necessitates comprehensive education and optimized transport.
- Telestroke services and prehospital candidate selection for endovascular therapy show promise.
- Innovative strategies are needed to increase the utilization of acute stroke treatments.
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