Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey
Background: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in patients with a pre-stroke disability, defin...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.714594/full |
| _version_ | 1818582330634141696 |
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| author | Sanjana Salwi Jan A. Niec Ameer E. Hassan Christopher J. Lindsell Pooja Khatri J. Mocco Jeffrey L. Saver Eva A. Mistry |
| author_facet | Sanjana Salwi Jan A. Niec Ameer E. Hassan Christopher J. Lindsell Pooja Khatri J. Mocco Jeffrey L. Saver Eva A. Mistry |
| author_sort | Sanjana Salwi |
| collection | DOAJ |
| description | Background: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in patients with a pre-stroke disability, defined as a modified Rankin score (mRS) ≥ 2.Methods: Electronic survey link was sent to principal investigators of five major EVT trials and members of a professional interventional neurology society.Results: Of the 81 survey-responding clinicians, 57% were neuro-interventionalists and 33% were non-interventional stroke clinicians. Overall, 64.2% would never or almost never consider EVT for a patient with pre-stroke mRS of 4-5, and 49.3% would always or almost always offer EVT for a patient with pre-stroke mRS 2-3. Perceived benefit of EVT (89%) and severity of baseline disability (83.5%) were identified as the most important clinician-level and patient-level factors that influence EVT decisions in these patients.Conclusion: In this survey of 80 respondents, we found that EVT practice for patients with pre-stroke disability across the world is heterogenous and depends upon patient characteristics. Individual clinician opinions substantially alter EVT decisions in pre-stroke disabled patients. |
| first_indexed | 2024-12-16T07:47:40Z |
| format | Article |
| id | doaj.art-8345c1430bca4db8ad50d883eb4640bb |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-16T07:47:40Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-8345c1430bca4db8ad50d883eb4640bb2022-12-21T22:38:56ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-10-011210.3389/fneur.2021.714594714594Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International SurveySanjana Salwi0Jan A. Niec1Ameer E. Hassan2Christopher J. Lindsell3Pooja Khatri4J. Mocco5Jeffrey L. Saver6Eva A. Mistry7School of Medicine, Vanderbilt University, Nashville, TN, United StatesSchool of Medicine, Vanderbilt University, Nashville, TN, United StatesDepartment of Neurology, University of Texas Rio Grande Valley, Harlingen, TX, United StatesDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United StatesDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, United StatesDepartment of Neurosurgery, Mount Sinai Health System, New York, NY, United StatesDepartment of Neurology, University of Calfornia, Los Angeles, Los Angeles, CA, United StatesDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, United StatesBackground: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in patients with a pre-stroke disability, defined as a modified Rankin score (mRS) ≥ 2.Methods: Electronic survey link was sent to principal investigators of five major EVT trials and members of a professional interventional neurology society.Results: Of the 81 survey-responding clinicians, 57% were neuro-interventionalists and 33% were non-interventional stroke clinicians. Overall, 64.2% would never or almost never consider EVT for a patient with pre-stroke mRS of 4-5, and 49.3% would always or almost always offer EVT for a patient with pre-stroke mRS 2-3. Perceived benefit of EVT (89%) and severity of baseline disability (83.5%) were identified as the most important clinician-level and patient-level factors that influence EVT decisions in these patients.Conclusion: In this survey of 80 respondents, we found that EVT practice for patients with pre-stroke disability across the world is heterogenous and depends upon patient characteristics. Individual clinician opinions substantially alter EVT decisions in pre-stroke disabled patients.https://www.frontiersin.org/articles/10.3389/fneur.2021.714594/fullischemic strokeendovascular treatmentacute stroketreatmentsurveydisability |
| spellingShingle | Sanjana Salwi Jan A. Niec Ameer E. Hassan Christopher J. Lindsell Pooja Khatri J. Mocco Jeffrey L. Saver Eva A. Mistry Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey Frontiers in Neurology ischemic stroke endovascular treatment acute stroke treatment survey disability |
| title | Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey |
| title_full | Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey |
| title_fullStr | Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey |
| title_full_unstemmed | Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey |
| title_short | Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey |
| title_sort | endovascular treatment for acute stroke patients with a pre stroke disability an international survey |
| topic | ischemic stroke endovascular treatment acute stroke treatment survey disability |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.714594/full |
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