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Cell Biology JoVE (Open Access) Citable · DOI

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

DOI: 10.3791/56397-v
What you'll learn
  • ✓ Implement ER protocols to minimize door-to-imaging time in acute ischemic stroke
  • ✓ Perform rapid diagnostic imaging assessment for EVT candidacy determination
  • ✓ Coordinate endovascular thrombectomy preparation and execution workflows
  • ✓ Achieve clinically optimized peri-procedural timings for reperfusion
Protocol

The outcome of patients with acute ischemic stroke depends on swift restoration of cerebral blood flow. This protocol aims at optimizing the management of such patients by minimizing peri-procedural timings and rendering the time from hospital admission to reperfusion as short as possible.

Difficulty
advanced
Total time
~45 min (door-to-reperfusion), variable by patient presentation

Steps

1
Execute emergency room triage and patient assessment

Rapidly perform initial patient evaluation, vital signs assessment, and baseline neurological examination upon hospital admission. Complete standardized documentation and activate stroke protocol within target 10-minute window.

▶ 01:15
2
Perform diagnostic imaging for EVT eligibility

Obtain and interpret CT/CTA imaging to assess acute ischemic stroke characteristics and endovascular thrombectomy candidacy. Complete diagnostic imaging within 15-minute target from hospital admission.

▶ 03:11
3
Prepare for and perform endovascular thrombectomy

Coordinate angiography suite preparation, position patient, and execute endovascular intervention including catheterization and thrombectomy. Target 10-minute preparation-to-intervention window following imaging completion.

▶ 06:10
4
Document and evaluate peri-procedural timing outcomes

Record actual door-to-reperfusion times and assess achievement of protocol optimization targets. Analyze results to identify workflow bottlenecks and success metrics.

▶ 07:51
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