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Specialist Perspectives on the Imaging Selection of Large Vessel Occlusion in the Late Window

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收录情况： ◇ SCIE

作者：
Piers Klein[1,2] * ; Xiaochuan Huo[3] ; Yimin Chen[4] ; Mohamad Abdalkader[2,5] ; Zhongming Qiu[6] ; SimonNagel[7,8] ; Jean Raymond[9] ; Liping Liu[10] ; James E. Siegler[11] ; Daniel Strbian[12] ; Thalia S. Field[13] ; Shadi Yaghi[14] ; Muhammad M. Qureshi[2] ; Jelle Demeestere[15] ; Volker Puetz[16,17] ; Anne Berberich[7] ; PatrikMichel[18] ; Urs Fischer[19] ; Johannes Kaesmacher[20] ; Hiroshi Yamagami[21] ; Fana Alemseged[22] ; Georgios Tsivgoulis[23] ; Wouter J. Schonewille[24] ; Wei Hu[25] ; Xinfeng Liu[25] ; Chuanhui Li[26] ; Xunming Ji[27] ; Brian Drumm[28] ; Soma Banerjee[28] ; Simona Sacco[29] ; Else C. Sandset[30] ; Espen Saxhaug Kristoffersen[31] ; Peter Slade[32] ; Robert Mikulik[33] ; Michele Romoli[34] ; Francesco Diana[35] ; Kailash Krishnan[36] ; Permesh Dhillon[37] ; Jin Soo Lee[38] ; Ekkehard Kasper[39,40] ; Hormuzdiyar Dasenbrock[39,40] ; MaiDuy Ton[41,42] ; RytisMasili ¯ unas[43] ; Anita Ante Arsovska[44] ; João PedroMarto[45] ; Adam A. Dmytriw[46,47] ; Robert W. Regenhardt[47] ; Gisele Sampaio Silva[48] ; Timo Siepmann[16,17] ; Dapeng Sun[3] ; Hongfei Sang[49] ; Jose Danilo Diestro[50] ; Pengfei Yang[51] ; Mahmoud H. Mohammaden[52] ; Fengli Li[53] ; HeshamE.Masoud[54] ; AliceMa[55] ; Raynald[3] ; Aravind Ganesh[56] ; Jianmin Liu[51] ; LukasMeyer[57] ; DiederikW. J.Dippel[58] ; Götz Thomalla[59] ; Mark Parsons[60] ; Adnan I. Qureshi[61] ; Mayank Goyal[62] ; Albert J. Yoo[63] ; Bertrand Lapergue[64] ; Osama O. Zaidat[65] ; Hui-Sheng Chen[66] ; Bruce C. V. Campbell[22,67] ; TudorG. Jovin[11] ; RaulG. Nogueira[68] ; Zhongrong Miao[3] ; Gustavo Saposnik[69] ; Thanh N. Nguyen[1,2,5,39,70] ;
机构： [1]Neurology, Boston Medical Center, Boston, USA [2]Radiology, Boston Medical Center, Boston, USA [3]Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China [4]Neurology, Foshan Sanshui District People’s Hospital, Foshan, China [5]Neurology, St. Elizabeth’s Medical Center, Boston, USA [6]Neurology, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China [7]Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany [8]Neurology, Heidelberg University Hospital, Heidelberg, Germany [9]Interventional Neuroradiology, Centre Hospitalier de l’Universite de Montreal, Montreal, Canada [10]Neurology, Beijing Tiantan Hospital, Beijing, China [11]Cooper Neurological Institute, Camden, USA [12]Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland [13]Neurology, University of British Columbia, Vancouver, Canada [14]Neurology, Rhode Island Hospital, Providence, USA [15]Neurology, Leuven University Hospital, Leuven, Belgium [16]Department of Neurology, University Hospital Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany [17]Dresden Neurovascular Center, University Hospital Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany [18]Stroke Center/Neurology, Lausanne University Hospital, Lausanne, Switzerland [19]Neurology, Basel University Hospital, Basel, Switzerland [20]Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland [21]Neurology, Osaka National Hospital, Osaka, Japan [22]Royal Melbourne Hospital, Melbourne, Australia [23]Neurology, Attikon University Hospital, Athens, Greece [24]Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands [25]Stroke Center, The First Affiliated Hospital of USTC, Hefei, China [26]Neurology, Xuanwu Hospital, Beijing, China [27]Neurosurgery, Xuanwu Hospital, Beijing, China [28]Stroke Medicine, Imperial College Healthcare, London, UK [29]Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy [30]Neurology, Oslo University Hospital, Oslo, Norway [31]Neurology, Akershus University Hospital, Akershus, Norway [32]Morriston Hospital, Swansea Hospital, Swansea, Wales, UK [33]Neurology, St Anne’s University Hospital, Brno, Czech Republic [34]Neurology, Bufalini Hospital, Cesena, Italy [35]Neuroradiology, University Hospital ‘San Giovanni di Dio e Ruggi d’Aragona’, Salerno, Italy [36]Stroke, Department of Acute Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK [37]Interventional Neuroradiology, Nottingham University Hospitals, Nottingham, UK [38]Neurology, Ajou University Hospital, Suwon, Korea (Republic of) [39]Neurosurgery, Boston Medical Center, Boston, USA [40]Neurosurgery, St. Elizabeth’s Medical Center, Boston, USA [41]Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam [42]Neurology, Vietnam National University of Medicine and Pharmacy, Hanoi, Vietnam [43]Center of Neurology, Vilnius University, Vilnius, Lithuania [44]Urgent Neurology, University Clinic of Neurology, Skopje, Macedonia [45]Neurology, Hospital de Egas Moniz, Lisbon, Portugal [46]Neurointerventional, London Health Sciences Centre, London, Canada [47]Neuroendovascular, Massachusetts General Hospital, Boston, USA [48]Universidade Federal de São Paulo (UNIFESP) and Hospital Israelita Albert Einstein, São Paulo, Brazil [49]Neurology, Affiliated Hangzhou First People’s Hospital, Hangzhou, China [50]Diagnostic and Therapeutic Neuroradiology, St Michael’s Hospital, University of Toronto, Toronto, Canada [51]Neurosurgery, Changhai Hospital, Shanghai, China [52]Neurology, Emory University, Atlanta, USA [53]Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China [54]Neurology, SUNY Upstate, Syracuse, USA [55]Royal North Shore Hospital, Sydney, Australia [56]Neurology, University of Calgary, Calgary, Canada [57]Interventionelle Neuroradiologie, Universitätsklinikum Hamburg- Eppendorf, Hamburg, Germany [58]Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands [59]Klinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany [60]South Western Sydney Clinical School, Liverpool Hospital, Liverpool, Australia [61]Zeenat Qureshi Stroke Institute, University of Missouri, Columbia, USA [62]Radiology, University of Calgary, Calgary, Canada [63]Neurointervention, Texas Stroke Institute, Dallas–Fort Worth, USA [64]Neurology, Hopital Foch, Suresnes, France [65]Neuroscience, Mercy Health St Vincent Hospital, Toledo, OH, USA [66]Neurology, General Hospital of Northern Theatre Command, Shenyang, China [67]University of Melbourne, Melbourne, Australia [68]Neurology, University of Pittsburgh Medical Center, Pittsburgh, USA [69]Stroke Outcomes and Decision Neuroscience Research Unit, University of Toronto, Toronto, Canada [70]Boston University Chobanian and Avedisian School of Medicine, Boston Medical Center, 85 East Concord Street, Boston, MA 02118, USA
出处：
DOI： 10.1007/s00062-023-01284-0
ISSN：

关键词： ASPECTS Endovascular thrombectomy Mechanical thrombectomy Late window Large vessel occlusion

摘要：
The proper imaging modality for use in the selection of patients for endovascular thrombectomy (EVT) presenting in the late window remains controversial, despite current guidelines advocating the use of advanced imaging in this population. We sought to understand if clinicians with different specialty training differ in their approach to patient selection for EVT in the late time window.We conducted an international survey of stroke and neurointerventional clinicians between January and May 2022 with questions focusing on imaging and treatment decisions of large vessel occlusion (LVO) patients presenting in the late window. Interventional neurologists, interventional neuroradiologists, and endovascular neurosurgeons were defined as interventionists whereas all other specialties were defined as non-interventionists. The non-interventionist group was defined by all other specialties of the respondents: stroke neurologist, neuroradiologist, emergency medicine physician, trainee (fellows and residents) and others.Of 3000 invited to participate, 1506 (1027 non-interventionists, 478 interventionists, 1 declined to specify) physicians completed the study. Interventionist respondents were more likely to proceed directly to EVT (39.5% vs. 19.5%; p < 0.0001) compared to non-interventionist respondents in patients with favorable ASPECTS (Alberta Stroke Program Early CT Score). Despite no difference in access to advanced imaging, interventionists were more likely to prefer CT/CTA alone (34.8% vs. 21.0%) and less likely to prefer CT/CTA/CTP (39.1% vs. 52.4%) for patient selection (p < 0.0001). When faced with uncertainty, non-interventionists were more likely to follow clinical guidelines (45.1% vs. 30.2%) while interventionists were more likely to follow their assessment of evidence (38.7% vs. 27.0%) (p < 0.0001).Interventionists were less likely to use advanced imaging techniques in selecting LVO patients presenting in the late window and more likely to base their decisions on their assessment of evidence rather than published guidelines. These results reflect gaps between interventionists and non-interventionists reliance on clinical guidelines, the limits of available evidence, and clinician belief in the utility of advanced imaging.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类 | 3 区 医学
小类 | 3 区 核医学 3 区 临床神经病学
最新[2023]版：
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 核医学
JCR分区：
出版当年[2021]版：
Q3 CLINICAL NEUROLOGY Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版：
Q2 CLINICAL NEUROLOGY Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者机构： [1]Neurology, Boston Medical Center, Boston, USA [2]Radiology, Boston Medical Center, Boston, USA
通讯作者：
通讯机构： [1]Neurology, Boston Medical Center, Boston, USA [2]Radiology, Boston Medical Center, Boston, USA [5]Neurology, St. Elizabeth’s Medical Center, Boston, USA [39]Neurosurgery, Boston Medical Center, Boston, USA [70]Boston University Chobanian and Avedisian School of Medicine, Boston Medical Center, 85 East Concord Street, Boston, MA 02118, USA
推荐引用方式(GB/T 7714)：
Piers Klein,Xiaochuan Huo,Yimin Chen,et al.Specialist Perspectives on the Imaging Selection of Large Vessel Occlusion in the Late Window[J].CLINICAL NEURORADIOLOGY.2023,33(3):801-811.doi:10.1007/s00062-023-01284-0.
APA：
Piers Klein,Xiaochuan Huo,Yimin Chen,Mohamad Abdalkader,Zhongming Qiu...&Thanh N. Nguyen.(2023).Specialist Perspectives on the Imaging Selection of Large Vessel Occlusion in the Late Window.CLINICAL NEURORADIOLOGY,33,(3)
MLA：
Piers Klein,et al."Specialist Perspectives on the Imaging Selection of Large Vessel Occlusion in the Late Window".CLINICAL NEURORADIOLOGY 33..3(2023):801-811

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