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Updated: Jan 24, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
A quantitative analysis of CT angiography, large vessel occlusion, and thrombectomy rates in acute ischaemic stroke
E Griffin1, D Herlihy2, R Hayden2
1Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin 9, Ireland; Royal College of Surgeons, 123 St Stephens Green, Dublin, Ireland.
Insights
Workload for acute computed tomography angiography (CTA) in suspected acute ischemic stroke (AIS) patients was analyzed. Large vessel occlusion (LVO) and thrombectomy rates varied significantly based on stroke diagnosis confirmation, highlighting the need for service planning.
Area of Science:
- Neurology
- Radiology
- Public Health
Background:
- Acute ischemic stroke (AIS) management relies on rapid diagnosis and intervention.
- Computed tomography angiography (CTA) is crucial for identifying large vessel occlusion (LVO) in AIS.
- Stroke center workload and thrombectomy rates require accurate assessment for service provision.
Purpose of the Study:
- To determine the workload of acute CTA in suspected AIS patients.
- To analyze rates of LVO and thrombectomy relative to stroke diagnoses.
- To compare these metrics across three Irish stroke centers.
Main Methods:
- Retrospective review of CTA data (2015-2017) from three stroke centers.
- Quantification of CTA studies, LVO, and thrombectomy rates.
- Correlation with hospital discharge diagnoses (HIPE system).
Main Results:
- 2,358 acute CTA studies were performed for suspected AIS.
- LVO rates were 18.4% (suspected AIS), 18.4% (discharge diagnosis), and 40.2% (confirmed AIS).
- Thrombectomy rates were 12% (suspected AIS), 12% (discharge diagnosis), and 26% (confirmed AIS).
Conclusions:
- Understanding CTA workload and LVO/thrombectomy rates is vital for stroke service planning.
- Rates differ significantly based on diagnostic certainty (suspected vs. confirmed AIS).
- Data is essential for optimizing acute stroke care delivery globally.
Aims:
To determine the workload of acute computed tomography angiography (CTA) in patients presenting with suspected acute ischaemic stroke (AIS) and rate of large vessel occlusion (LVO) and thrombectomy relative to suspected and confirmed stroke diagnoses across three stroke centres within the Republic of Ireland.
Materials And Methods:
A retrospective review of data from three stroke centres, one of which provides a 24-hour thrombectomy service was undertaken. The number of CTA studies performed from January 2015 to December 2017 for suspected AIS was quantified using the national PACS in addition to occlusion location, collateral status, and rates of LVO and thrombectomy. The hospital inpatient enquiry (HIPE) system was searched for all patients with a primary discharge diagnosis of stroke and then correlated with patients who underwent CTA on admission.
Results:
A total of 2,358 CTA studies were performed for suspected AIS during the study period across three stroke centres. LVO was demonstrated in 18.4% of suspected AIS, 18.4% of primary discharge stroke diagnoses, and 40.2% of confirmed AIS who underwent CTA. A total of 283 thrombectomies were performed of which 64.6% were LVO. Thrombectomy was performed in 12% of suspected AIS, 12% of overall primary discharge diagnoses of stroke cases, and 26% of confirmed stroke who underwent CTA.
Conclusion:
Establishing the volume of acute CTAs and rates of LVO and thrombectomy when compared to suspected AIS on admission, confirmed stroke diagnoses who underwent CTA and primary discharge diagnosis of stroke is essential for the planning and provision of stroke services worldwide.
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