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dc.contributor.authorNguyen, Thanh
dc.contributor.authorKlein, Piers
dc.contributor.authorBerberich, Anne
dc.contributor.authorNagel, Simon
dc.contributor.authorAbdalkader, Mohamad
dc.contributor.authorHerning, Ana
dc.contributor.authorKristoffersen, Espen Saxhaug
dc.contributor.authorSandset, Else Charlotte
dc.date.accessioned2023-01-06T14:14:06Z
dc.date.available2023-01-06T14:14:06Z
dc.date.issued2022-12-31
dc.description.abstractBackground - Current stroke guidelines recommend advanced imaging (computed tomography [CT] perfusion or magnetic resonance imaging) prior to endovascular therapy (EVT) in patients with late presentation of large vessel occlusion. Adherence to guidelines may be constrained by resources or timely access to imaging. We sought to understand the factors which influence late window imaging selection for EVT candidates with large vessel occlusion.<p> <p>Methods - We conducted an international survey from January to May 2022. The questions aimed to identify advanced imaging and treatment decisions based on access to imaging, time delays, and simulated patient scenarios.<p> <p>Results - There were 3000 invited participants and 1506 respondents, the majority (89.6%) from comprehensive stroke centers in high‐income countries. Neurointerventionalists comprised 31.8% and noninterventionalists 68.2% of respondents. Overall, 70.7% reported routine use of advanced imaging for late EVT selection, and 63.6% reported its usage in every case. There was greater availability of advanced imaging in comprehensive stroke centers versus primary stroke centers (67.0% versus 33.7%; P<0.0001), and high‐ versus low‐middle income countries (70.5% versus 44.5%; P<0.0001). When presented with a late window patient, 41.6% would complete CT perfusion or magnetic resonance imaging prior to EVT, 25.4% would perform CT perfusion or magnetic resonance imaging prior to IVT and EVT, and 25.8% would refer to EVT without advanced imaging. If advanced imaging was not readily available, 70.1% would refer a patient to EVT based on CT in the late window. Additional time delay within 20 minutes to obtain advanced imaging was considered acceptable in 77.7% of respondents.<p> <p>Conclusion - Current guidelines for imaging late window EVT candidates are inconsistent with imaging decisions by physicians. Most respondents consider an imaging delay of greater than 20 minutes unacceptable. Access to advanced imaging was greater in comprehensive stroke centers and high‐income countries. In the case of limited access most respondents would consider EVT based on CT only.en_US
dc.identifier.citationNguyen, Klein, Berberich, Nagel, Abdalkader, Herning, Kristoffersen, Sandset. Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey. Stroke: Vascular and Interventional Neurology. 2022en_US
dc.identifier.cristinIDFRIDAID 2100582
dc.identifier.doi10.1161/SVIN.122.000595
dc.identifier.issn2694-5746
dc.identifier.urihttps://hdl.handle.net/10037/28068
dc.language.isoengen_US
dc.publisherAmerican Heart Associationen_US
dc.relation.journalStroke: Vascular and Interventional Neurology
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleLate Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Surveyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution 4.0 International (CC BY 4.0)