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Updated: May 30, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

[Time lost between stroke and carotid endarterectomy].

Dennis E J G J Dolmans¹, Gert Jan de Borst, Alexander te Slaa

¹Atrium Medisch Centrum, afd. Heelkunde, Heerlen, the Netherlands.

Nederlands Tijdschrift Voor Geneeskunde

|August 13, 2011

Summary

Measures to shorten the time between stroke and carotid endarterectomy (CEA) improved surgical timing. However, most patients still did not receive CEA within two weeks, indicating a need for semi-acute procedures.

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Area of Science:

Vascular Surgery
Neurology
Healthcare Management

Context:

Carotid endarterectomy (CEA) is a crucial procedure for preventing recurrent stroke in patients with symptomatic carotid artery stenosis.
Optimizing the timing of CEA after stroke is essential for maximizing patient benefit and reducing complication risks.
Previous care pathways may have led to delays in surgical intervention.

Purpose:

To evaluate the effectiveness of implemented measures aimed at reducing the time interval between stroke onset and carotid endarterectomy (CEA).
To compare pre- and post-intervention 'pass-through' intervals for CEA at a non-academic teaching hospital and a university medical center.
To assess whether hospital care sequence improvements impacted the timeliness of CEA procedures.

Summary:

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia

Published on: September 16, 2017

Following interventions to expedite care, the percentage of patients undergoing CEA within two weeks increased significantly from baseline (5.5%-10.5%) to 34% (Amphia Ziekenhuis) and 21% (UMCU) in 2010.
The median time from stroke symptoms to CEA decreased substantially at both institutions, from 40 to 19 days at Amphia Ziekenhuis and from 57 to 36 days at UMCU.
Despite improvements, a majority of symptomatic patients did not undergo CEA within the critical two-week window in 2010.

Impact:

The study highlights the need to reclassify CEA from a semi-elective to a semi-acute procedure to meet future performance criteria.
Findings suggest that further streamlining of hospital care pathways is necessary to achieve timely CEA for stroke patients.
The results provide valuable insights for healthcare providers and policymakers aiming to improve stroke care protocols and reduce the risk of secondary events.