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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Stroke 20 20: Implementation goals for intravenous thrombolysis
Robert Mikulik1,2, Michal Bar3, David Cernik4
1International Clinical Research Center and Department of Neurology, St. Anne's University Hospital Brno, Brno, Czech Republic.
European Stroke Journal
|August 20, 2021
Summary
Intravenous thrombolysis for stroke care has significantly improved, with rates reaching over 20% of ischemic strokes. National targets, like the Stroke 20-20 initiative, are crucial for optimizing treatment times and accessibility.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Intravenous thrombolysis (IVT) for stroke is underutilized globally.
- Identifying implementation gaps is key to increasing IVT adoption.
- This study aimed to establish national targets for IVT utilization and logistics.
Purpose of the Study:
- To define national implementation targets for intravenous thrombolysis in stroke care.
- To assess the feasibility of achieving specific utilization and logistical goals for IVT.
Main Methods:
- A multicomponent intervention strategy was implemented across 45 national stroke centers.
- Data on IVT utilization and door-to-needle times were prospectively collected.
- Thrombolytic rates were calculated based on the total number of ischemic strokes.
Main Results:
- Thrombolytic rates increased from 1.3% in 2005 to 23.5% in 2018.
- National median door-to-needle times improved from 60-70 minutes to 25 minutes by 2018.
- In 2018, 39% of patients received IVT within 20 minutes of arrival.
Conclusions:
- Nationwide IVT can be provided to over 20% of ischemic stroke patients.
- Achieving a median door-to-needle time of 20 minutes is a realistic national target.
- Country-specific policies are essential for reaching national IVT implementation goals.
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