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Interfacility Transfer for Thrombectomy: A Promising Therapeutic Window.

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Delays during interfacility transfer for acute ischemic stroke patients undergoing thrombectomy are common. Understanding clinical and radiological changes during transfer is crucial for improving patient outcomes and developing new therapeutic strategies.

Keywords:
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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Emergency Medicine

Background:

  • Most acute ischemic stroke patients with large vessel occlusion are initially treated at non-thrombectomy-capable centers.
  • Interfacility transfer to thrombectomy-capable centers is often delayed due to complex coordination, negatively impacting clinical outcomes.

Purpose of the Study:

  • To review clinical and radiological changes during interfacility transfer for thrombectomy.
  • To explore therapeutic strategies for reducing infarct growth during transfer.
  • To discuss trial design considerations for optimizing care during this critical period.

Main Methods:

  • Literature review summarizing clinical and radiological changes.
  • Analysis of infarct growth, collateral changes, recanalization, and hemorrhagic transformation.
  • Discussion of therapeutic interventions and clinical trial methodologies.

Main Results:

  • Clinical and radiological changes during transfer are heterogeneous among patients.
  • These changes significantly impact long-term functional outcomes.
  • Evidence suggests potential benefits from strategies like penumbral protection.

Conclusions:

  • Optimizing care during interfacility transfer is urgently needed.
  • Further research and clinical trials are essential to reduce infarct growth and improve outcomes for stroke patients.
  • Understanding transfer-related changes is key to developing effective interventions.