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Medical Societies Issue Revised, Patient-Centered Stroke Guidelines

Revised guidelines for the nonsurgical, image-guided interventional treatment of acute ischemic stroke will ensure patients receive the right treatment at the right time. The updated guidelines, endorsed by the Society of Interventional Radiology (SIR) and 11 other medical societies, were published in the April edition of SIR's peer-reviewed journal, the Journal of Vascular and Interventional Radiology.

This revision updates standards of practice was first published in 2013 and establishes 15 metrics on patient care and outcomes, based on findings of recent scientific studies about interventions such as thrombectomy (clot removal) and revascularization (opening blocked arteries). The 2018 guidelines cover important factors in selecting patients for interventional treatments and ensuring optimal outcomes, such as the time since the patient was "last known well," preprocedural imaging, and clot location.

"The one constant in stroke treatment is time to opening the artery," notes David Sacks, MD, FSIR, an interventional radiologist at Reading Hospital/Tower Health in West Reading, Pennsylvania, and the lead author of the standards. "Seconds count from time of admission to successful treatment. Meeting the outcomes described in these guidelines will ultimately benefit patients by requiring strict adherence to a rapid treatment schedule."

The benchmarks set in this revised guideline are intended for use in quality improvement programs to assess and improve processes and outcomes and may also help facilities meet the criteria for accreditation as a comprehensive stroke center. 

"We know from recent studies that rapid access to interventional treatments increases the odds of survival and decreases the occurrence of disability in patients who suffered an acute ischemic stroke," says M. Victoria Marx, MD, FSIR, SIR president and a professor of clinical radiology at the Keck School of Medicine of the University of Southern California. "Now is the time for these guidelines to be adopted and applied to save lives."

The societies joining SIR in the guidelines are the American Association of Neurological Surgeons, American Society of Neuroradiology, Canadian Association for Interventional Radiology (formerly the Canadian Interventional Radiology Association), Cardiovascular and Interventional Radiological Society of Europe, Congress of Neurological Surgeons, European Society of Minimally Invasive Neurologic Therapy, European Society of Neuroradiology, European Stroke Organization, Society for Cardiovascular Angiography and Interventions, Society of NeuroInterventional Surgery, and World Stroke Organization.