Angiography, rather than the conventional computed tomography (CT scan), reduced stroke treatment time and was associated with better recovery, according to late science presented today at the International Stroke Conference of the American Stroke Association 2021. The virtual meeting is March 17- 19, 2021 and is a major global meeting for researchers and clinicians dedicated to the science of stroke and brain health.
Routine emergency department treatment for stroke patients includes a CT scan, which uses X-rays to identify the presence and location of a blood clot. Angiography is an advanced method of X-ray imaging that uses a catheter, or thin tube, inserted into the blood vessel to determine the location and extent of the obstruction. Because every minute counts at the time of a stroke, this study focused on determining whether immediate angiography improved treatment time and recovery, compared with conventional CT scans.
Our study is the first clinical trial to demonstrate the superiority of direct transfer to a series of angiography. Our conclusions were close to expectations, and we were surprised that they occurred so early in the study. We hope that they will be tested in continuous, multifunctional, international testing. “
Manuel Requena, Ph.D., Lead Author, Neurologist and Neurointerventionalist Fellow, Vall d’Hebron Hospital in Barcelona, Spain
Starting in October 2018, patients with a stroke were admitted to Vall d’Hebron Hospital within six hours of the onset of a stroke symptom by a suspected blood vessel randomly assigned to get a cardiac angiography or CT scan. There were 150 stroke patients by November 2020; the average age of the patients was 73 years, and more than half were male.
In this interim analysis, stroke patients assigned for angiography were tested within 19 minutes of admission to hospital – less than half of the 43 minutes for patients who received CT scan. Similarly, stroke patients assigned to angiography received endovascular treatment to restore blood flow 54 minutes faster, on average, compared with CT scan recipients.
At 90 days after stroke, angiography patients were more likely than CT scan patients to show a 1-point improvement on the 6-point scale that measures stroke disability.
“Stroke patients who were transferred directly to angiography series were less likely to rely on help with daily activities compared to stroke patients who received the standard level of care – CT scan,” Requena said. “More frequent and faster treatment can help improve outcomes for our stroke patients.”
Many national and international professional bodies including the American Stroke Association have proposed general stroke recommendations based on the currently available evidence to monitor the time from emergency room arrival to delivery. restore blood flow to the blocked brain artery to reduce the risk of severe disability and death. However, data highlighting the urgent need for ongoing monitoring of ischemic stroke treatment are limited.
The limitation of this study is that the hospital already had extensive experience with immediate angiography, so results may vary at hospitals or care centers with less or no angiography experience. Another limitation is that the results of the study were not reviewed by an external review body.
According to the American Heart Association Heart and Stroke Statistics – Update 2021, when assessed separately from other cardiovascular disease, stroke ranks No. 5 among all causes of death in the U.S., causing 147,810 deaths in 2018. A stroke occurs when a blood vessel closes. to or in the brain either blocked or exploding, preventing blood and oxygen from reaching the entire brain. Treatment to restore blood flow to the brain is essential to improve results and survival.
Source:
American Heart Association