International survey of acute stroke imaging used to make revascularization treatment decisions.
- Wintermark M Department of Radiology, Neuroradiology, Stanford University, Palo Alto, CA, USA.
- Luby M National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA.
- Bornstein NM Department of Neurology, Elias Sourasky Medical Centre, Sackler Faculty of Medicine, Tel-Aviv, Israel.
- Demchuk A Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
- Fiehler J Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Kudo K Department of Diagnostic Radiology, Hokkaido University Hospital, Sapporo, Japan.
- Lees KR University Department of Medicine & Therapeutics, Western Infirmary, University of Glasgow, Glasgow, UK.
- Liebeskind DS Department of Neurology, UCLA Stroke Center, Los Angeles, CA, USA.
- Michel P Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland.
- Nogueira RG Marcus Stroke & Neuroscience Center/Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA.
- Parsons MW Department of Neurology, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
- Sasaki M Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan.
- Wardlaw JM Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
- Wu O Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Zhang W Department of Neurology, Military General Hospital of Beijing PLA, Beijing, China.
- Zhu G Department of Neurology, Military General Hospital of Beijing PLA, Beijing, China.
- Warach SJ Seton/UT Southwestern Clinical Research Institute of Austin, Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Austin, TX, USA.
- 2015-04-03
Published in:
- International journal of stroke : official journal of the International Stroke Society. - 2015
CT
MRI
penumbra
perfusion imaging
stroke
vascular imaging
Decision Making
Diagnostic Imaging
Female
Follow-Up Studies
Humans
International Cooperation
Male
Randomized Controlled Trials as Topic
Stroke
Surveys and Questionnaires
Thrombolytic Therapy
Time Factors
English
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.
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.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1111/ijs.12491
- PMID 25833105
- Persistent URL
- https://folia.unifr.ch/global/documents/293581
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