Stroke

Cardiovascular departments are playing a role in stroke interventions at numerous health systems, working as part of the stroke care team with neurologists, radiology and the emergency department. Stroke first has be be classified as ischemic or hemorrhagic. These have very different care pathways. Ischemic strokes are increasingly being treated with neurological-interventional therapy that includes catheter based mechanical thrombectomy to remove the clot. This is a more aggressive treatment compared to traditional IV administration of tissue plasminogen activator (tPA) thrombolytic therapy to dissolve the clot. Subarachnoid hemorrhage (SAH) and  intracerebral hemorrhage (ICH) brain bleeds can also be treated in some cases stent flow diverters and embolization coils. 

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Sentinel Boston Scientific PROTECTED TAVR stroke disabling stroke

TAVR embolic protection devices fail to reduce stroke risk, but some cardiologists—and a leading vendor—remain encouraged

The PROTECTED TAVR results presented at TCT 2022 resulted in a mix of reactions. For some cardiologists, the slight reduction in the risk of a disabling stroke after TAVR is a positive result. For others, it was simply not enough. 

Ischemic stroke shown in CT scans. Image courtesy of RSNA

VIDEO: AI for stroke detection on CT imaging

Bibb Allen, MD, FACR, chief medical officer of the American College of Radiology (ACR) Data Science Institute, explains the trend of using AI for the automated detection of stroke on computed tomography (CT) imaging and the need to include radiologists on the stroke care team.

Ischemic stroke CT imaging. Images courtesy of RSNA

Experts highlight early ischemic signs on CT that can estimate onset of stroke

Experts involved in the research believe their findings could help to guide providers in making treatment decisions. 

Some neurovascular imaging studies are overutilized in stroke triage

Triaging patients with stroke-like symptoms using MRI with diffusion-weighted imaging (DWI) could reduce the cost burden associated with unnecessary neurovascular imaging procedures. 

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'One-stop-shop' CT protocol saves time, reduces radiation needed for acute stroke imaging

The protocol does not come at the expense of deteriorated image quality, according to work published recently in the European Journal of Radiology.

Expansion of open-source neuroimaging dataset aims to boost stroke research

Researchers recently revamped the database in the hopes of expanding algorithm development in the field of stroke care. 

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70% of ‘mini-stroke’ patients imaged incompletely, risking full-on stroke

Emergency patients diagnosed with transient ischemic attack are supposed to receive, per multiple society guidelines, a complete imaging workup as soon as possible—preferably within 48 hours of ED discharge.

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New bleeding stroke guidelines highlight several common treatments that may be ineffective

The updated document, developed by the American Heart Association and American Stroke Association, also emphasizes the potential benefits of caregiver training and MR imaging. 

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