The Advanced Reperfusion Era: Implications for Emergency Systems of Ischemic Stroke Care.
Large vessel ischemic stroke is a leading cause of morbidity and mortality throughout the world. Recent advances in endovascular stroke treatment are changing the treatment paradigm for these patients. This concepts article summarizes the time-dependent nature of stroke care and evaluates the recent advancements in endovascular treatment. These advancements have significant implications for out-of-hospital, hospital, and regional systems of stroke care. Emergency medicine clinicians have a central role in implementing these systems that will ensure timely treatment of patients and selection of those who may benefit from endovascular care.
Department of Emergency Medicine, Henry Ford Hospital and Wayne State University, Detroit, MI; Department of Internal Medicine, Henry Ford Hospital and Wayne State University, Detroit, MI. Electronic address: jmiller6@hfhs.org.
Joseph B
JB
Miller
Department of Emergency Medicine and the Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, RI.
Lisa H
LH
Merck
Department of Emergency Medicine and the Department of Neurology, Yale School of Medicine, New Haven, CT.
Charles R
CR
Wira
Department of Emergency Medicine and the Department of Neurology, University of Michigan, Ann Arbor, MI.
William J
WJ
Meurer
Department of Emergency Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
Jon W
JW
Schrock
Department of Emergency Medicine and the Department of Neurosciences, Christiana Care Health System, Newark, DE.
Jason T
JT
Nomura
Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.
Matthew S
MS
Siket
Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.
Tracy E
TE
Madsen
Department of Emergency Medicine, Emory University School of Medicine and Grady Memorial Hospital, Atlanta, GA.
David W
DW
Wright
Department of Emergency Medicine and the Department of Neurology, Washington University, St Louis, MO.
Peter D
PD
Panagos
Department of Emergency Medicine, Henry Ford Hospital and Wayne State University, Detroit, MI.
Christopher
C
Lewandowski
D001807:Blood Vessel Prosthesis; D004636:Emergency Service, Hospital; D057510:Endovascular Procedures; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D015607:Stents; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy
D005343:Fibrinolytic Agents