How important is timing of treatment after ischemic stroke?

This study looked at endovascular treatment for ischemic stroke and the link between stroke onset and beginning treatment. The authors established that shorter time from stroke to treatment resulted in better recovery in ischemic stroke patients.

Endovascular treatment (EVT) involves minimally invasive procedures to remove blood clots from blood vessels. It has been shown to be an effective treatment of acute ischemic stroke (blockage in an artery carrying blood to the brain). For the treatment to be as effective as possible, it’s been suggested that it should be carried out as soon as possible after stroke onset.

This study aimed to assess the link between time from stroke to EVT treatment and successful recovery.

1488 patients who underwent EVT after ischemic stroke were included. Of these, 742 patients had successful reperfusion (return of normal blood flow). Patients underwent a follow up after an average of 90 days. Average time from stroke onset to EVT was 208 minutes and treatment took an average of 1 hour.

Longer time from stroke onset to EVT was associated with 17% poorer recovery for every hour delay. The probability of patients regaining full independence was reduced by 5.3% per hour delay of EVT treatment. The risk of death was increased by 2.2% per hour delay of EVT treatment.

For the 742 patients who had successful reperfusion, longer time from stroke onset to EVT treatment was associated with 21% poorer recovery. The probability of these patients regaining full independence was reduced by 7.7% per hour delay of treatment.

The authors concluded that time to EVT after stroke onset is associated with recovery. They state that successful recovery can be greatly improved by shortening time from stroke onset to EVT treatment.