Background: Over the last decade, acute stroke treatment has gone through significant changes. The changes started with the intravenous tPA treatment and were followed by intra-arterial thrombectomy ( IAT). IAT became established only three years ago after a number of positive trials were published.
Objectives: To determine if the changes in stroke guidelines affected the percentage of patients treated with IV tPA or IAT, and if increased experience improved rapidity of treatment.
Methods: A retrospective, single academic center study extrapolated from the Soroka Stroke Database between the dates of January 2013 and July 2017. Analysis of descriptive statistics was conducted and some of the results were shown in the graph in order to demonstrate trends.
Results: Between January 2013 and July 2017, 3656 patients were admitted to Soroka Medical Center with the diagnosis of ischemic stroke. During the study period, there was a 50-minute decrease in median time for door-to-CT scan, although the door-to-needle time for tPA treatment did not change. However, over the study period, there was an increase in the percentage of patients receiving IV tPA from 10% to 14% and a 12% increase in the number of patients undergoing IAT.
Conclusions: Soroka data reflect the changes in stroke treatment guidelines.
Discussion: Our study demonstrates a mild increase in the percentage of patients being treated with IV tPA together with a very sharp increase in the percentage of stroke patients undergoing IAT. This data directly reflects the guideline changes of the last decade. We also saw a significant improvement in door-CT time.