Improving Regional Stroke Systems of Care

Melissa S. Eng, Anand V. Patel, Richard B. Libman, Paul Wright, Jeffrey M. Katz

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Acute ischemic stroke (AIS) care is rapidly evolving. This review discusses current diagnostic, therapeutic, and process models that can expedite stroke treatment to achieve best outcomes. Recent Findings: Use of stent retrievers after selection via advanced imaging is safe and effective, and is an important option for AIS patients with large vessel occlusion (LVO). Significant time delays occur before and during patient transfers, and upon comprehensive stroke center (CSC) arrival, and have deleterious effects on functional outcome. Removing obstacles, enhancing inter-facility communication, and creating acute stroke management processes and protocols are paramount strategies to enhance network efficiency. Inter-departmental CSC collaboration can significantly reduce door-to-treatment times. Summary: Streamlined stroke systems of care may result in higher treatment rates and better functional outcomes for AIS patients, simultaneously conserving healthcare dollars. Stroke systems of care should be structured regionally to minimize time to treatment. A proactive approach must be employed; a management plan incorporating stroke team prenotification and parallel processes between departments can save valuable time, maximize brain salvage, and reduce disability from stroke.

Original languageEnglish (US)
Article number52
JournalCurrent Atherosclerosis Reports
Volume19
Issue number12
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

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Keywords

  • Comprehensive stroke center (CSC)
  • Endovascular stroke therapy (EST)
  • Large vessel occlusion (LVO)
  • Stroke imaging
  • Stroke networks
  • Stroke screening tools
  • Stroke systems

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Improving Regional Stroke Systems of Care. / Eng, Melissa S.; Patel, Anand V.; Libman, Richard B.; Wright, Paul; Katz, Jeffrey M.

In: Current Atherosclerosis Reports, Vol. 19, No. 12, 52, 01.12.2017.

Research output: Contribution to journalReview article