International survey of acute stroke imaging used to make revascularization treatment decisions.

Details

Serval ID
serval:BIB_055B1ABF7A60
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
International survey of acute stroke imaging used to make revascularization treatment decisions.
Journal
International Journal of Stroke
Author(s)
Wintermark M., Luby M., Bornstein N.M., Demchuk A., Fiehler J., Kudo K., Lees K.R., Liebeskind D.S., Michel P., Nogueira R.G., Parsons M.W., Sasaki M., Wardlaw J.M., Wu O., Zhang W., Zhu G., Warach S.J.
ISSN
1747-4949 (Electronic)
ISSN-L
1747-4930
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
10
Number
5
Pages
759-762
Language
english
Notes
Publication types: Journal Article ; Multicenter Study publication Status: ppublish
Abstract
BACKGROUND: To assess the differences across continental regions in terms of stroke imaging obtained for making acute revascularization therapy decisions, and to identify obstacles to participating in randomized trials involving multimodal imaging.
METHODS: STroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA)-Imaging circulated an online survey through its website, through the websites of national professional societies from multiple countries as well as through email distribution lists from STIR and the above mentioned societies.
RESULTS: We received responses from 223 centers (2 from Africa, 38 from Asia, 10 from Australia, 101 from Europe, 4 from Middle East, 55 from North America, 13 from South America). In combination, the sites surveyed administered acute revascularization therapy to a total of 25,326 acute stroke patients in 2012. Seventy-three percent of these patients received intravenous (i.v.) tissue plasminogen activator (tPA), and 27%, endovascular therapy. Vascular imaging was routinely obtained in 79% (152/193) of sites for endovascular therapy decisions, and also as part of standard IV tPA treatment decisions at 46% (92/198) of sites. Modality, availability and use of acute vascular and perfusion imaging before revascularization varied substantially between geographical areas. The main obstacles to participate in randomized trials involving multimodal imaging included: mainly insufficient research support and staff (50%, 79/158) and infrequent use of multimodal imaging (27%, 43/158) .
CONCLUSION: There were significant variations among sites and geographical areas in terms of stroke imaging work-up used tomake decisions both for intravenous and endovascular revascularization. Clinical trials using advanced imaging as a selection tool for acute revascularization therapy should address the need for additional resources and technical support, and take into consideration the lack of routine use of such techniques in trial planning.
Keywords
Decision Making, Diagnostic Imaging, Female, Follow-Up Studies, Humans, International Cooperation, Male, Stroke/diagnosis, Stroke/therapy, Surveys and Questionnaires, Thrombolytic Therapy/methods, Time Factors
Pubmed
Web of science
Create date
20/07/2015 10:00
Last modification date
20/08/2019 12:27
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