title: Expanding the treatment window for ischemic stroke through the application of novel system-based technology.
abstract: Recent randomized controlled trials have demonstrated the superiority of endovascular treatment (ET) over medical management in the treatment of acute ischemic stroke patients with anterior circulation emergent large vessel occlusions (ELVOs). Due to such accumulating evidence, expanding ET has become of paramount importance. Advancements in modern technology have enabled the use of mobile stroke units, telestroke networks, mobile neuroendovascular teams, and smartphone applications that shorten the time window to treatment and, thus, make patients more amenable to ET. Additionally, modifying stroke-screening tools to make them more accessible to first responders and the creation of stroke registries can provide further opportunities for ET.
authors.affiliation: Department of Neurosurgery.
authors.forename: Mohammad
authors.initials: M
authors.lastname: El-Ghanem
authors.affiliation: Department of Neurosurgery.
authors.forename: Fawaz
authors.initials: F
authors.lastname: Al-Mufti
authors.affiliation: Rutgers University, New Jersey Medical School, Newark, New Jersey.
authors.forename: Venkatraman
authors.initials: V
authors.lastname: Thulasi
authors.affiliation: Department of Neurosurgery.
authors.forename: Inder Paul
authors.initials: IP
authors.lastname: Singh
authors.affiliation: Department of Neurosurgery.
authors.forename: Chirag
authors.initials: C
authors.lastname: Gandhi
mesh_terms: D002545:Brain Ischemia / Q000150:complications; D057510:Endovascular Procedures / Q000379:methods*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007276:Injections, Intraventricular; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: CPSSS = Cincinnati Prehospital Stroke Severity Scale; ELVO = emergent large vessel occulion; EMS; EMS = emergency medical services; ET = endovascular treatment; FAST-ED = Field Assessment Stroke Triage for Emergency Destination; KMET = Kanazawa mobile embolectomy team; MSU = mobile stroke unit; NIHSS = National Institutes of Health Stroke Scale; PASS = Prehospital Acute Stroke Severity; RACE = Rapid Arterial Occlusion Evaluation; VAN = Vision, Aphasia, Neglect; acute stroke; emergent large vessel occlusion; endovascular treatment; mechanical thrombectomy; mobile stroke unit; prehospital stroke scale; tPA = tissue plasminogen activator; telestroke