In 2015, five landmark trials demonstrated the benefit of opening large vessel occlusion strokes in select patients suffering a stroke within an 8 hour time window. In 2017, the DAWN trial demonstrated benefit of extending this window out to select patients presenting with wake–up strokes or unwitnessed onset stroke up to a 24-hour window.
At Boston Medical Center, our Neuroendovascular and Stroke teams are committed to providing rapid, safe and effective treatment of these patients 24/7/365. We value our partnerships with our EMS, ER, Neurology and Hospitalist colleagues at Primary Stroke Centers in identifying these patients early and providing streamlined care of these patients.
To discuss building interfacility protocol and transfer of these patients, please contact: Thanh Nguyen at thanh.nguyen@bmc.org
To refer a patient, please call our Acute Stroke Hotline:
1.844.BMC.4.CVA (1.844.262.4282)
Patient Stories
References:
- Nogueira RG, Jadhav A, Haussen DC, Bonafe A, Budzik RF, ... Jovin TG et al. Thrombectomy 6 to 24 hours after Stroke with Mismatch between Deficit and Infarct. NEJM November 11, 2017.
- Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, Ortega-Gutierrez S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med January 24, 2018.
- Goyal M, Menon BK, van Zam WH, Dippel DW, Mitchell PJ, Demchuk AM, Davlos A, et al. HERMES Collaborators. Endovascular thrombectomy after large vessel ischemic stroke: a meta-analysis of individual patient data from five randomized trials. Lancet 2016;387:1723-1731.
- Goyal M, Demchuk AM, Menon BK et al. Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke. N Engl J Med. February 11, 2015
- Campbell CV, Mitchell PJ, Kleinig et al. Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection. N Engl J Med. February 11, 2015
- Berkhemer OA, Fransen PSS, Beumer D... Dippel WJ et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 2015;372:11-20.
- Smith EE, Hassan KA, Fang J, Selchen D, Kapral MK, Saposnik G, on behalf of the Investigators of the Registry of the Canadian Stroke Network (RCSN) for the Stroke Outcome Research Canada (SORCan) Working Group. Do all ischemic stroke subtypes benefit from organized inpatient stroke care?NEUROLOGY 2010;75:456-462
- Nguyen TN, Abdalkader M, Jovin TG, Nogueira RG, Jadhav AP, Haussen DC, Hassan AE, Novakovic R, Sheth SA, Ortega-Gutierrez S, Panagos PD, Cordina SM, Linfante I, Mansour OY, Malik AM, Narayanan S, Masoud HE, Chou SH, Khatri R, Janardhan V, Yavagal DR, Zaidat OO, Greer DM, Liebeskind DS. Mechanical Thrombectomy in the Era of the COVID-19 Pandemic: Emergency Preparedness for Neuroscience Teams: A Guidance Statement From the Society of Vascular and Interventional Neurology. Stroke. 2020 06; 51(6):1896-1901
- Nguyen TN, Abdalkader M, Nagel S, Qureshi MM, Ribo M, Caparros F, et al. Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion. JAMA Neurol. 2022 01 01; 79(1):22-31
- Seker F, Qureshi MM, Möhlenbruch MA, Nogueira RG, Abdalkader M, Ribo M, et al. Reperfusion Without Functional Independence in Late Presentation of Stroke With Large Vessel Occlusion. Stroke. 2022 Oct 14