The impact of evidence: evolving therapy for acute ischemic stroke in a large healthcare system

BackgroundWith a recent surge of clinical trials, the treatment of ischemic stroke has undergone dramatic changes.ObjectiveTo evaluate the impact of evidence and a revamped stroke protocol on a large healthcare system.MethodsA retrospective review of 69 patients with ischemic stroke treated with intra-arterial therapy was carried out. Cohort 1 included patients treated before implementation of a new stroke protocol, and cohort 2 after implementation. Angiographic outcome was graded using the Thrombolysis in Cerebral Infarction (TICI) score. Clinical outcomes were assessed using the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS).ResultsPrimary outcomes comparing cohorts demonstrated decreased arrival-to-puncture time (cohort 2: 104 vs cohort 1: 181 min, p