Emergency Medicine Literature of Note - May 5, 2016 - Posted By Ryan Radecki
"Endovascular intervention for acute stroke can be quite useful – in appropriately selected patients. However, few centers are capable of such interventions, and the technology to properly angiographically evaluated for large-artery occlusions is not available in all settings. Thus, it is just as critical for patients to be clinically screened in some fashion to prevent over-utilization of scarce resources...
The authors’ conclusions are reasonable, if a little limited. They feel every patient presenting with an acute stroke within 6 hours of symptom onset should undergo vascular imaging. These are both reasonable, but ignore one of the major uses for simple clinical scoring systems: prehospital triage. Admitting none of these are perfect, _something_ must be put to use – and, probably, given the current bandwidth for endovascular intervention, something with the highest specificity.