Number of ischemic strokes potentially eligible for revascularization treatments in an Italian Comprehensive Stroke Center: a modeling study

To rationally plan acute services, the proportion of ischemic strokes that may be eligible for revascularization treatments should be estimated. We aimed to estimate the proportion of patients directly admitted to an Italian Comprehensive Stroke Center who may be eligible for intravenous thrombolysi...

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Bibliographic Details
Published in:Journal of thrombosis and thrombolysis 2018-10, Vol.46 (3), p.427-430
Main Authors: Forlivesi, Stefano, Bonetti, Bruno, Cappellari, Manuel
Format: Article
Language:English
Subjects:
Adult
Brain Ischemia
Cardiology
Cardiovascular system
Cerebral Revascularization
Data processing
Female
Hematology
Humans
Intravenous administration
Ischemia
Italy
Male
Medicine
Medicine & Public Health
Middle Aged
Models, Theoretical
Patients
Practice Guidelines as Topic
Retrospective Studies
Stroke
Stroke - pathology
Stroke - surgery
Stroke - therapy
Thrombectomy
Thrombolysis
Thrombolytic Therapy
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Summary:To rationally plan acute services, the proportion of ischemic strokes that may be eligible for revascularization treatments should be estimated. We aimed to estimate the proportion of patients directly admitted to an Italian Comprehensive Stroke Center who may be eligible for intravenous thrombolysis (IVT), combined IVT and endovascular thrombectomy (ET), or direct ET according to the current guidelines. We conducted a retrospective analysis based on data prospectively collected from 876 consecutive adult ischemic stroke patients who were directly admitted to the Stroke Unit of the University Hospital of Verona within 12 h of stroke onset. A theoretical model was created to calculate the proportion of patients potentially eligible for revascularization treatments. In our cohort, 289 (33%) patients would be eligible for IVT alone, 193 (22%) for combined IVT and ET, and 39 (4%) for direct ET with level of evidence IA according to the current guidelines. According to our theoretical model, more than half of the ischemic stroke patients directly admitted to Verona Stroke Unit within 12 h of stroke onset would be eligible for IVT and more than a quarter for ET. Systems of care should promptly organize to offer each patient the best treatment.
ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-018-1712-4