Imaging of Patients with Suspected Large-Vessel Occlusion at Primary Stroke Centers: Available Modalities and a Suggested Approach

AJNR Am J Neuroradiol. 2019 Mar;40(3):396-400. doi: 10.3174/ajnr.A5971. Epub 2019 Jan 31.

Abstract

The overwhelming benefit of endovascular therapy in patients with large-vessel occlusions suggests that more patients will be screened than treated. Some of those patients will be evaluated first at primary stroke centers; this type of evaluation calls for standardizing the imaging approach to minimize delays in assessing, transferring, and treating these patients. Here, we propose that CT angiography (performed at the same time as head CT) should be the minimum imaging approach for all patients with stroke with suspected large-vessel occlusion presenting to primary stroke centers. We discuss some of the implications of this approach and how to facilitate them.

MeSH terms

  • Aged
  • Computed Tomography Angiography / methods
  • Endovascular Procedures
  • Female
  • Hospital Units* / organization & administration
  • Hospital Units* / standards
  • Humans
  • Male
  • Middle Aged
  • Neuroimaging / methods*
  • Neuroimaging / standards*
  • Patient Transfer
  • Stroke / diagnostic imaging*
  • Stroke / therapy
  • Time-to-Treatment
  • Tomography, X-Ray Computed
  • Workflow