Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Melanie Hardin-Pierce

Clinical Mentor

Lynn Hundley

Committee Member

Dr. Sheila Melander

Abstract

Objective: The DEFUSE 3 and DAWN trials have revealed that stroke patients may be eligible for mechanical thrombectomy up to 24 hours from symptom onset with appropriate perfusion imaging. The purpose of the study is to evaluate the impact CTP imaging will have patient selection and outcomes at a Comprehensive Stroke Center.

Methods: This study is a retrospective and prospective chart review comparing acute ischemic stroke patients evaluated for mechanical thrombectomy utilizing CT angiogram verses CT perfusion imaging from January 1, 2018- June 30th 2019 at a Comprehensive Stroke Center.

Results: Of the 129 patients who received CTAs, 36 patients received mechanical thrombectomy. This is compared to the 73 patients that received CTP scanning, and 26 patients were found to be eligible for mechanical thrombectomy. There were no significant findings regarding patient selection for mechanical thrombectomy regarding the number of patients that received mechanical thrombectomy, complication rates, and change in NIHSS from admission to discharge.

Conclusion: The addition of CTP imaging at the Comprehensive Stroke Center demonstrated that patients can successfully be given mechanical thrombectomy in the extended intervention window of up to 24 hours from last known well.

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