Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey

作者：Thanh N. Nguyen, Piers Klein, Anne Berberich, Simon Nagel, Mohamad K. Abdalkader, Ana Herning, Yimin Chen, Xiaochuan Huo, Zhongrong Miao, Sunil A. Sheth, Muhammad M. Qureshi, James Ernest Siegler, Simona Sacco, Daniel Strbian, Urs Fischer, Hiroshi Yamagami, Espen Saxhaug Kristoffersen, Volker Puetz, Wouter J. Schonewille, Georgios K. Tsivgoulis, Brian Drumm, Soma Banerjee, Jelle Demeestere, Fana Alemseged, Else Charlotte Sandset, Anita Ante Arsovska, Kailash Krishnan, Permesh Singh Dhillon, Ángel Corredor, Rodrigo Rivera, Petra Šedová, Robert Mikulík, Hesham E. Masoud, Sheila Cristina Ouriques Martins, Thang Huy Nguyen, Mai Duy Ton, Xinfeng Liu, Yuyou Zhu, Fengli Li, Wan Asyraf Wan Zaidi, Marialuisa Zedde, Shadi Yaghi, Jian Miao, Violiza Inoa, Liqun Zhang, Rytis Masiliūnas, Peter Michael Edward Slade, Sarah Shali Matuja, João Pedro Marto, Patrik Michel, Jens Fiehler, Götz Thomalla, Alicia C. Castonguay, Maxim V. Mokin, Mark William Parsons, Bruce C.V. Campbell, Dileep R. Yavagal, Diederik W.J. Dippel, Mayank Goyal, Osama O. Zaidat, Tudor G. Jovin, Wei Hu, Raul G. Nogueira, Zhongming Qiu, Jean Raymond, Gustavo Saposnik · 发表于：Stroke Vascular and Interventional Neurology · 年份：2022 · DOI：10.1161/svin.122.000595 · 被引用次数：43 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Peripheral Artery Disease Management

Background 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. 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. 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 advan...