Abstract
SUMMARY
The overwhelming benefit of endovascular therapy in patients with large-vessel occlusions suggests that more patients will be screened than treated. Some of those patients will be evaluated first at primary stroke centers; this type of evaluation calls for standardizing the imaging approach to minimize delays in assessing, transferring, and treating these patients. Here, we propose that CT angiography (performed at the same time as head CT) should be the minimum imaging approach for all patients with stroke with suspected large-vessel occlusion presenting to primary stroke centers. We discuss some of the implications of this approach and how to facilitate them.
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Imaging of Patients with Suspected Large-Vessel Occlusion at Primary Stroke Centers: Available Modalities and a Suggested Approach
Editor’s Choice
Endovascular thrombectomy has proven efficacy for a wide range of patients with large-vessel occlusion stroke and in selected cases up to 24 hours from onset. While primary stroke centers have increased the proportion of patients with stroke receiving thrombolytic therapy, delays can be encountered until patients with LVO are identified and transferred from the primary stroke center to a comprehensive stroke center. Therefore, any extra steps need to be carefully weighed. The use of CTA (especially multiphase) at the primary stroke center level has many advantages in expediting the transfer of appropriate patients to a comprehensive center.