Neuroradiology | 2021
Adapting pre-hospital stroke triage systems to expanding thrombectomy indications
Abstract
Acute ischemic stroke (AIS) leads to severe disability if left untreated, particularly when it is caused by a large vessel occlusion (LVO) [1]. In 2015 however, when several randomized controlled trials showed safety and efficacy of endovascular treatment (EVT) for LVO stroke, the prognosis of these patients has dramatically changed. This evidence has translated into current guidelines, which recommend vascular imaging in all AIS patients upon hospital arrival. If an LVO is identified, EVT is recommended in patients who meet certain clinical inclusion criteria [2]. One of these criteria is the presence of disabling deficits, i.e., a baseline National Institutes of Health Stroke score of 6 or higher [2]. This clinical severity threshold forms the basis for clinical stroke triage tools such as the Los Angeles Motor Scale (LAMS) [3] and the Rapid Arterial Occlusion Evaluation scale (RACE) [4].