Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
Original Articles
The Diagnosis and Management of Acute Stroke with Emergent Large Vessel Occlusion Screen
Naoya ImaiMitsunori IshiguroShingo YonezawaYuko NonakaShigeru HaraSeiji Fukazawa
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JOURNAL OPEN ACCESS

2021 Volume 15 Issue 12 Pages 800-804

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Abstract

Objective: Endovascular therapy (EVT) is a well-documented treatment for acute occlusion of major cerebral arteries. We carried out in-hospital triage using the emergency large vessel occlusion (ELVO) screen, a pre-hospital scale for acute stroke, to diagnose EVT cases and considered its efficacy.

Methods: We investigated stroke cases examined within 24 hours of onset in a 6-month period beginning on March 15, 2019. The results of ELVO screen were retrospectively considered with the presence of atrial fibrillation and treatment of EVT.

Results: A total of 146 cases were included. Of the 65 positive ELVO screen cases, 33 (51%) had large vessel occlusion (LVO). Of the 81 negative ELVO screen cases, 11 (14%) had LVO (sensitivity, 75%; specificity, 69%; positive predictive value, 51%; negative predictive value, 86%; accuracy, 71%; P <0.001). Among LVO cases, 16 of the 33 (48%) positive ELVO screen cases and 2 of the 11 (18%) negative ELVO screen cases were treated by EVT. Complications of atrial fibrillation were significantly more common in positive ELVO screen cases (P = 0.001). EVT was carried out in nearly half of the positive ELVO screen cases of atrial fibrillation, being a significantly higher rate (10 of 24 cases, 42%; P = 0.02).

Conclusion: The accuracy of EVT use increased in positive ELVO screen cases, particularly in those with atrial fibrillation. In-hospital triage using ELVO screen, a pre-hospital scale, significantly aided in selecting patients requiring EVT.

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© 2021 The Japanese Society for Neuroendovascular Therapy

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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