دورية أكاديمية
Endovascular therapy for anterior circulation emergent large vessel occlusion stroke in patients with large ischemic cores: a report of the SNIS Standards and Guidelines Committee.
| العنوان: | Endovascular therapy for anterior circulation emergent large vessel occlusion stroke in patients with large ischemic cores: a report of the SNIS Standards and Guidelines Committee. |
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| المؤلفون: | Al-Mufti, Fawaz, Marden, Franklin A, Burkhardt, Jan Karl, Raper, Daniel, Schirmer, Clemens M, Baker, Amanda, Chen, Peng Roc, Bulsara, Ketan R, Narsinh, Kazim H, Amans, Matthew Robert, Cooper, Jared, Yaghi, Shadi, Al-Kawaz, Mais, Hetts, Steven W, Baxter, Blaise W, MD |
| المصدر: | Department of Radiology & Diagnostic Medical Imaging |
| بيانات النشر: | LVHN Scholarly Works |
| سنة النشر: | 2024 |
| المجموعة: | Lehigh Valley Health Network: LVHN Scholarly Works |
| مصطلحات موضوعية: | Department of Radiology and Diagnostic Medical Imaging, Diagnosis, Medicine and Health Sciences, Other Analytical, Diagnostic and Therapeutic Techniques and Equipment, Radiology |
| الوصف: | BACKGROUND: Early clinical trials validating endovascular therapy (EVT) for emergent large vessel occlusion (ELVO) ischemic stroke in the anterior circulation initially focused on patients with small or absent completed infarctions (ischemic cores) to maximize the probability of detecting a clinically meaningful and statistically significant benefit of EVT. Subsequently, real-world experience suggested that patients with large core ischemic strokes (LCS) at presentation may also benefit from EVT. Several large, retrospective, and prospective randomized clinical trials have recently been published that further validate this approach. These guidelines aim to provide an update for endovascular treatment of LCS. METHODS: A structured literature review of LCS studies available since 2019 and grading the strength and quality of the evidence was performed. Recommendations were made based on these new data by consensus of the authors, with additional input from the full SNIS Standards and Guidelines Committee and the SNIS Board of Directors. RESULTS: The management of ELVO strokes with large ischemic cores continues to evolve. The expert panel agreed on several recommendations: Recommendation 1: In patients with anterior circulation ELVO who present within 24 hours of last known normal with large infarct core (70-149 mL or ASPECTS 3-5) and meet other criteria of RESCUE-Japan LIMIT, SELECT2, ANGEL-ASPECT, TESLA, TENSION, or LASTE trials, thrombectomy is indicated (Class I, Level A). Recommendations 2-7 flow directly from recommendation 1. Recommendation 2: EVT in patients with LCS aged 18-85 years is beneficial (Class I, Level A). Recommendation 3: EVT in patients with LCS >85 years of age may be beneficial (Class I, Level B-R). Recommendation 4: Patients with LCS and NIHSS score 6-30 benefit from EVT in LCS (Class I, Level A). Recommendation 5: Patients with LCS and NIHSS score30 may benefit from EVT in LCS (Class IIa, Level A). Recommendation 6: Patients with LCS and low baseline mRS (0-1) benefit from EVT (Class ... |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://scholarlyworks.lvhn.org/radiology-diagnostic-medical-imaging/1047Test; https://pubmed.ncbi.nlm.nih.gov/38395601Test/ |
| الإتاحة: | https://scholarlyworks.lvhn.org/radiology-diagnostic-medical-imaging/1047Test https://pubmed.ncbi.nlm.nih.gov/38395601Test/ |
| رقم الانضمام: | edsbas.9B488B51 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |