Adopting a “CTA-for-All” policy helped radiologists detect large vessel occlusion (LVO) and improved outcomes for patients with acute ischemic stroke, according to a recent study published in Stroke.
Currently, CT angiography (CTA) is only ordered for patients who arrive at the hospital within six hours of last known well (last known time a patient was without symptoms), with a National Institutes of Health Stroke Scale (NIHSS) score of six or greater. CTA-for-All, however, expands imaging—including non-contrast CT— to patients who present within 24 hours of last known well, without considering their NIHSS score.
After comparing outcomes between stroke patients admitted to the hospital one year before and one year after implementing the new policy, the researchers reported shorter times between emergency department arrival and CTA. Lead author Stephan A. Mayer, MD, and colleagues at Henry Ford Hospital in Detroit also detected more instances of LVO and reported better outcomes.
“These findings suggest that a uniform CTA-for-All imaging policy for stroke patients presenting within 24 hours is feasible and safe, improves LVO detection, speeds intervention and can improve outcomes,” Mayer et al. wrote. “The benefit appears to primarily affect patients presenting within six hours of symptom onset."
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