[Optimised rate of specific, revascularising therapies in acute stroke--what is the aim? Considerations from the experience of a tertiary centre]. / Optimierte rate spezifischer revaskularisierender therapien beim akuten ischämischen schlaganfall--was ist das ziel? Erwägungen anhand der erfahrungen eines tertiären versorgungszentrums.

ABSTRACT

BACKGROUND: Recanalisation favourably influences outcome in acute stroke. Improved endovascular approaches seem to have higher recanalisation rates than systemic thrombolysis. Substantial efforts have been undertaken to increase the proportion of patients to whom these therapies can be applied. It is still unclear what rates can be realised in a clinical setting. PATIENTS AND METHODS: This is a retrospective single-centre analysis of patients with acute ischaemic stroke and specific recanalisation therapy primarily admitted to our tertiary care centre from 1/2010 to 3/2012. RESULTS: 20 % of patients received systemic thrombolysis, 20 % of these additional endovascular strategies. Pathological multimodal CT patterns were more common in patients not fulfilling the inclusion criteria for thrombolysis. Short-term clinical outcomes were similar in on-label and off-label applications. CONCLUSION: Structured clinical pathways including multimodal CT imaging are useful in identifying patients likely to profit from revascularisation therapies. Based upon our data, some realistic aims concerning therapy rates in patients with ischaemic stroke treated in everyday practice may be formulated (20/20 in 2020).