Availability Of Thrombolytic Therapy After Optimization Of The Prehospital Stage Of Stroke Care
Abstract
Intravenous thrombolytic therapy is one of the most effective treatments for ischemic stroke; however, its benefit declines rapidly as time from symptom onset increases, which restricts its use to a narrow therapeutic window [1]. For large-vessel occlusion, endovascular thrombectomy has also become a standard of care [2]. Algorithms for prehospital diagnosis and routing can reduce time delays and increase access to reperfusion therapy [3, 4], which is essential for improving clinical outcomes.
Aim of the study. To evaluate the impact of prehospital stage optimization on the rate of reperfusion (thrombolytic and endovascular) therapy in patients with acute cerebrovascular accident (ACVA).
References
Emberson J., Lees K.R., Lyden P. et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials // Lancet. – 2014. – Vol. 384, № 9958. – P. 1929–1935.
Goyal M., Menon B.K., van Zwam W.H. et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials // Lancet. – 2016. – Vol. 387, № 10029. – P. 1723–1731.
Berglund A., Svensson L., Sjöstrand C. et al. Higher prehospital priority level of stroke improves thrombolysis frequency and time to stroke unit: the Hyper Acute STroke Alarm (HASTA) study // Stroke. – 2012. – Vol. 43, № 10. – P. 2666–2670.
Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association // Stroke. – 2019. – Vol. 50, № 12. – P. e344–e418.
