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Large Vessel Occlusion Stroke Detection in the Prehospital Environment

PURPOSE OF REVIEW: Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detec...

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Detalles Bibliográficos
Autores principales: Patrick, Lauren, Smith, Wade, Keenan, Kevin J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534324/
https://www.ncbi.nlm.nih.gov/pubmed/36204242
http://dx.doi.org/10.1007/s40138-021-00234-9
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author Patrick, Lauren
Smith, Wade
Keenan, Kevin J.
author_facet Patrick, Lauren
Smith, Wade
Keenan, Kevin J.
author_sort Patrick, Lauren
collection PubMed
description PURPOSE OF REVIEW: Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients. RECENT FINDINGS: Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients. SUMMARY: The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway.
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spelling pubmed-95343242022-10-05 Large Vessel Occlusion Stroke Detection in the Prehospital Environment Patrick, Lauren Smith, Wade Keenan, Kevin J. Curr Emerg Hosp Med Rep Article PURPOSE OF REVIEW: Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients. RECENT FINDINGS: Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients. SUMMARY: The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway. 2021-09 2021-06-28 /pmc/articles/PMC9534324/ /pubmed/36204242 http://dx.doi.org/10.1007/s40138-021-00234-9 Text en https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Patrick, Lauren
Smith, Wade
Keenan, Kevin J.
Large Vessel Occlusion Stroke Detection in the Prehospital Environment
title Large Vessel Occlusion Stroke Detection in the Prehospital Environment
title_full Large Vessel Occlusion Stroke Detection in the Prehospital Environment
title_fullStr Large Vessel Occlusion Stroke Detection in the Prehospital Environment
title_full_unstemmed Large Vessel Occlusion Stroke Detection in the Prehospital Environment
title_short Large Vessel Occlusion Stroke Detection in the Prehospital Environment
title_sort large vessel occlusion stroke detection in the prehospital environment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534324/
https://www.ncbi.nlm.nih.gov/pubmed/36204242
http://dx.doi.org/10.1007/s40138-021-00234-9
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