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Updated: Jan 24, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
[Consensus on acute ischemic stroke]
Santiago G Pigretti1, Matías J Alet1, Carlos E Mamani2
1Sociedad Neurológica Argentina, Argentina.
Insights
This consensus outlines updated protocols for managing ischemic stroke, aiming to reduce patient mortality and disability in Argentina. It emphasizes timely care, from pre-hospital to hospital management, including advanced therapies.
Area of Science:
- Neurology
- Public Health
- Emergency Medicine
Background:
- Stroke is a leading cause of death and disability in Argentina, with ischemic events comprising 80% of cases.
- Systematized protocols are crucial for reducing stroke care time, morbidity, and mortality.
Framework:
- Developed through collaboration among specialists from nine medical societies focused on cerebrovascular disease.
- Recommendations were formulated based on the best available clinical evidence, adapted for local applicability.
- The American Heart Association system was utilized for grading recommendations and their evidence levels.
Implementation:
- Expert work groups, comprising members from diverse medical specialties, drafted specific chapters.
- Recommendations underwent rigorous review and editing by external experts in vascular pathology.
- A final general meeting ensured consensus on all recommendations before finalization.
Implications:
- The consensus provides comprehensive guidance on ischemic stroke management, from pre-hospital care to in-hospital treatment.
- Covers critical aspects including emergency evaluation, recanalization therapies (thrombolysis, mechanical thrombectomy), decompressive craniectomy, neuroimaging, and clinical care.
- Aims to improve stroke outcomes by standardizing and optimizing patient care pathways nationwide.
Abstract:
Stroke is the third cause of death and the first cause of disability in Argentina. Ischemic events constitute 80% of cases. It requires the implementation of systematized protocols that allow reducing the time of care, morbidity and mortality. Specialists from nine medical societies related to the care of patients with cerebrovascular disease participated in the consensus. A separate agenda was agreed upon in chapters and for the writing of them, work groups were formed with members of different medical specialties. The level of recommendation was discussed and agreed upon for each topic based on the best clinical evidence available for each of them. An adaptation to the local scope of the recommendations was made when it was considered necessary.The American Heart Association system was used to draft the recommendations and their level of evidence. The correction and editing were done by five external reviewers, who did not participate in the writing and with extensive experience in vascular pathology. Once the preliminary document was finalized, a general meeting was held with all the members of the working groups and the reviewers to reach final recommendations. The consensus covers the management of ischemic stroke in the pre-hospital phase, initial evaluation in the emergency center, recanalization therapies (thrombolysis and/ or mechanical thrombectomy), decompressive craniectomy, neuroimaging and clinical care in the hospital.
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