Generalization of the right acute stroke promotive strategies in reducing delays of intravenous thrombolysis for acute ischemic stroke

Abstract

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Effects of time delays on the therapeutic outcomes of intravenous thrombolysis for acute ischemic stroke in the posterior circulation: An observational study

“…These results may be due to the benefits of a higher rate of recanalization after endovascular therapy being offset by longer time delays in OTT. Therefore, efforts made to reduce time delays for IVT and to increase the rate of patients treated in the “golden hour,” such as with the application of treatment in novel settings with a mobile stroke unit and the optimization of work flows in traditional hospital settings, deserve increased attention and should be generalized (Huang, Zhang, Xu, & Wu, ). It is noteworthy that there were no significant differences in the safety and efficacy of ultra‐early IVT between the two settings (Tsivgoulis, Geisler, et al, ; Tsivgoulis, Katsanos, et al, ), highlighting the key role of prompt IVT initiation, regardless of treatment location.…”

Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis

“…Delays in stroke recognition by paramedics and hospital staff, delays in obtaining and interpreting brain imaging, inefficiencies in emergency stroke care, delays in obtaining treatment consent, an absence of decision support systems and protocols in emergency care facilities and physician perception of IVT efficacy and safety have also been identified as major factors that limit IVT implementation [ 5 ]. Consequently, several, often multi-faceted intervention strategies have been tested in efforts to improve the rates of IVT in AIS [ 7 ]. Such intervention strategies include telemedicine and ‘hub-spoke’ models, pre- and/or in-hospital notification, multi-disciplinary collaborative approaches and re-organisation of pre-hospital and hospital systems of care [ 4 , 7 ].…”

“…Consequently, several, often multi-faceted intervention strategies have been tested in efforts to improve the rates of IVT in AIS [ 7 ]. Such intervention strategies include telemedicine and ‘hub-spoke’ models, pre- and/or in-hospital notification, multi-disciplinary collaborative approaches and re-organisation of pre-hospital and hospital systems of care [ 4 , 7 ].…”

“…The first systematic review, published in 2016, only included studies that met the Cochrane collaboration standards for practice and organisation of care study design criteria [ 8 ]. The second and third systematic reviews and meta-analyses were published in 2018 and 2019 [ 4 , 7 ]. Both studies expressed the meta-analyses results based on various intervention approaches, but they did not use any specific operational definitions or theoretical approaches when grouping the studies in the analyses [ 4 , 7 ].…”

“…The second and third systematic reviews and meta-analyses were published in 2018 and 2019 [ 4 , 7 ]. Both studies expressed the meta-analyses results based on various intervention approaches, but they did not use any specific operational definitions or theoretical approaches when grouping the studies in the analyses [ 4 , 7 ]. Moreover, neither study explored publication bias when describing group-based results [ 4 , 7 ], despite the importance of this information to data interpretation.…”