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Updated: Jun 7, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Management of acute stroke: impact of registration studies
1Division of Cerebrovascular Disorders, Department of Neurology, Carver College of Medicine, University of Iowa Health Care Stroke Center, University of Iowa, Iowa City, Iowa 52242, USA. harold-adams@uiowa.edu
Insights
Effective stroke care requires collaboration and integrated regional programs. Strategies include training, care plans, and telemedicine to extend timely treatment, especially reperfusion therapies, to more patients.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- Stroke is a leading cause of death and disability, incurring significant healthcare costs and lost productivity.
- While prevention has advanced, acute care, particularly reperfusion therapies, offers potential cures but has a narrow time window.
- Modern stroke management necessitates collaboration among the public, healthcare providers, administrators, insurers, and government.
Purpose of the Study:
- To propose strategies for extending modern stroke care to a broader patient population.
- To outline an integrated approach for emergency stroke treatment, from primary community hospitals to comprehensive stroke centers.
- To identify Taiwan as a suitable location for developing regional stroke programs.
Main Methods:
- Developing educational programs for emergency medical service personnel and physicians.
- Establishing stroke care plans at community hospitals.
- Implementing an integrated community-comprehensive stroke center program utilizing consultation and telemedicine.
Main Results:
- The proposed integrated model aims to provide timely emergency treatments, including intravenous thrombolytics, at primary stroke centers.
- Patients requiring advanced care would be evacuated to comprehensive stroke centers with specialized resources.
- Taiwan's healthcare infrastructure is well-suited for the development of such regional stroke management programs.
Conclusions:
- An integrated, collaborative approach is crucial for optimizing acute stroke care delivery.
- Regional stroke programs incorporating primary and comprehensive centers, supported by telemedicine, can improve patient outcomes.
- Taiwan offers a promising environment for implementing and evaluating these advanced stroke care models.
Abstract:
Stroke is a life-threatening or life-changing disease that is expensive in health care costs and lost productivity. Stroke also is a leading cause of human suffering. While the risk of stroke may be reduced with advances in prevention, recent advances in acute care can limit the consequences of stroke. In particular, the success of reperfusion therapies including intra-arterial interventions and intravenous administration of thrombolytic agents means that some patients with stroke may be cured. Still, the time window for effective treatment of stroke is relatively short. As a result, modern stroke management requires the close collaboration of the public, health care providers, administrators, insurance companies, and the government. Potential strategies to extend modern stroke care to as many patients as possible include 1) educational programs to train community emergency medical service personnel and physicians, 2) development of stroke care plans at community hospitals, 3) an integrated community-comprehensive stroke center program based on consultation, and telemedicine. The goal is to have a highly integrated approach to provide emergency treatment of the stroke that provides key emergency treatment, including intravenous administration of thrombolytic medications, at a community hospital (primary stroke center) with evacuation to a comprehensive stroke center that has resources and expertise that are not available in the primary stroke center. Taiwan is an ideal location for the development of such regional stroke programs.
