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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Endovascular thrombectomy at low-volume centres: A Bayesian solution.

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Summary
This summary is machine-generated.

General interventional radiologists can effectively perform endovascular treatment (EVT) for large vessel occlusion (LVO) stroke. This approach achieves outcomes comparable to specialized centers, improving access to care in underserved areas.

Keywords:
acute treatmentendovascular treatmentgeneral interventional radiologistslarge vessel occlusionstrokethrombectomy

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Area of Science:

  • Neurology
  • Interventional Radiology
  • Vascular Medicine

Background:

  • Endovascular treatment (EVT) for large vessel occlusion (LVO) stroke is typically performed by neurointerventional radiologists at specialized centers.
  • This creates access challenges for patients in rural areas due to long transport times.

Purpose of the Study:

  • To evaluate the technical and clinical outcomes of EVT for LVO stroke performed by general interventional radiologists.
  • To assess the feasibility of this approach in a hospital without dedicated neurointerventional expertise.

Main Methods:

  • A retrospective analysis of 235 patients with LVO stroke treated with EVT between May 2009 and December 2018.
  • Outcomes measured by modified treatment in cerebral ischemia (mTICI) scores for technical success and modified Rankin Scale (mRS) for functional outcome.
  • Complications were systematically registered.

Main Results:

  • Recanalization rates (mTICI 2b or 3) improved over time, reaching a stable rate of around 80% after 2014.
  • Good functional outcomes (mRS 0-2) were achieved in over 40% of patients after the introduction of aspiration techniques, with 61.1% in 2018.
  • EVT performed by general interventional radiologists yielded results consistent with international standards.

Conclusions:

  • General interventional radiologists, in collaboration with neuroradiologists and neurologists, can achieve successful EVT for LVO stroke.
  • This model of care can expand EVT accessibility in regions lacking neurointerventional specialists.
  • The study demonstrates the potential to bridge the gap in stroke care delivery.