Editorials

Selecting patients for endovascular treatment of acute stroke

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2059 (Published 03 May 2017) Cite this as: BMJ 2017;357:j2059
  1. José G Merino, US research editor, The BMJ
  1. Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
  1. jmerino{at}som.umaryland.edu
  2. Research, doi:10.1136/bmj.j1710

New prediction tool will improve decision making at a critical time

Endovascular thrombectomy improves functional outcome in patients with severe stroke due to an occlusion of the internal carotid artery or proximal middle cerebral artery if the procedure is started within six hours from symptom onset. A recent meta-analysis found that, compared with standard treatment, for every 1000 patients undergoing endovascular thrombectomy in addition to standard medical treatment, 167 more will attain a good outcome.1 The benefit is greatest for patients treated in the earliest time windows.2

In many countries, endovascular thrombectomy is the standard of care for eligible patients.3 But provision of this treatment requires expertise and resources that are not available in all hospitals. To improve access, regional systems of care have been reorganised to allow rapid identification and transfer …

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