Large-vessel occlusion, large thrombus burden acute stroke in acute pulmonary embolism: A single multi-specialty multi-skill team treatment optimization

Clinical Outcomes of Extracranial Carotid Artery-Related Stroke Eligible for Mechanical Reperfusion on Top of Per-Guidelines Thrombolytic Therapy: Analysis from a 6-Month Consecutive Patient Sample in 2 Centers

“…However, we showed that the health benefit gain for these patients can be very high ( Figure 3 ). Establishing of center-specific standard operating procedures and a multispecialty team approach can play an important role in creating a delay-free process [ 29 ]. Stroke mechanical reperfusion should be offered within high-volume cardiovascular centers (Level 2 stroke centers – TCSCs) and performed by operators trained in both carotid interventions and MT [ 49 , 50 ].…”

“…Stroke mechanical reperfusion should be offered within high-volume cardiovascular centers (Level 2 stroke centers – TCSCs) and performed by operators trained in both carotid interventions and MT [ 49 , 50 ]. Cardioangiology-run (in collaboration with local stroke neurology physicians) [ 24 , 29 ] Level 2 stroke centers (TCSCs, providing 100% AIS-CA acceptance rate in our cohort) can play an important role in improving patient access to stroke mechanical reperfusion [ 49 , 51 , 52 ]. These centers may be able to not only accept and effectively treat AIS-CA patients ( Figures 2 , 3 ), but also manage the excess volume of conventional intracranial LVO patients [ 29 , 52 ].…”

“…Cardioangiology-run (in collaboration with local stroke neurology physicians) [ 24 , 29 ] Level 2 stroke centers (TCSCs, providing 100% AIS-CA acceptance rate in our cohort) can play an important role in improving patient access to stroke mechanical reperfusion [ 49 , 51 , 52 ]. These centers may be able to not only accept and effectively treat AIS-CA patients ( Figures 2 , 3 ), but also manage the excess volume of conventional intracranial LVO patients [ 29 , 52 ]. Our regional CSC (the only center formally part of the national stroke MT reimbursement system [ 52 ]) is theoretically supposed to serve a population of about 3.5 million, but this far exceeds its practical capacities (guidelines indicate 1 interventional stroke center per 0.5–1 million population, which in our study cohort might have been a potential reason for rejection of EMR-eligible patients) [ 51 ].…”

“…Prospective data collection involved all consecutive patients with AIS receiving cerebral and vascular imaging in 2 collaborating centers with acute stroke neurology. Study Center 1 is a high-volume major tertiary 24/7 cardiovascular center with carotid artery stenting (CAS) expertise with a case load of 350-400 CAS procedures per year [26][27][28] and MT service under World Federation for Stroke Treatment (WIST) certification and supervision (Level-2 stroke center -Thrombectomy-Capable Stroke Center, TCSC) [24,29]. In addition, vascular surgery treatments (including carotid endarterectomy of »200 cases per year) are performed [26][27][28].…”

“…In addition, vascular surgery treatments (including carotid endarterectomy of »200 cases per year) are performed [26][27][28]. A multispecialty local Stroke Endovascular Mechanical Reperfusion Team with interventional cardiology and angiology, stroke neurology, radiology, and anesthesia is operational within the Level-2 WIST stroke center framework [24,29].…”