With the emphasis on reducing time from ‘last known normal’ to recanalization, acute stroke therapy requires rapid, accurate diagnosis for treatment decision-making. The authors reviewed 850 stroke thrombolysis patients in a single institution, separated into two groups: the earlier protocol patients received only a non-contrast CT, while the later group underwent initial non-contrast CT with CTA. There were no differences in median door-to-needle times or median onset-to-needle times. The authors concluded that adding CTA to their acute stroke imaging protocol did not significantly change their interval to thrombolysis. While a brief and focused study, this report is important to practitioners in stroke intervention. Adding workup studies prior to administration of therapy (IV-tPA or intra-arterial thrombolysis) incurs potential risks of delaying treatment. The authors demonstrate that this is not to the case for CTA, which adds value in selecting appropriate patients for intra-arterial endovascular treatment.
Canadian Journal of Neurological Sciences