Is my patent a good candidate for reperfusion therapy (IV thrombolytics (IVT) and/or interventional procedures)?

Do not use a single tool to determine reperfusion eligibility. Consider clinical severity (NIHSS), CT findings (ASPECTS), thrombectomy benefit (PRE), bleeding risk (HAT or SEDAN) and contraindications to IVT to guide treatment decisions.

Algorithm

Treatment

Contraindications to Intravenous Thrombolysis (IVT) for Ischemic Stroke

Absolute and relative contraindications to IVT; aids in risk-benefit determination

Use this tool when

Determining candidacy for IVT

Diagnosis

Prognosis

NIH Stroke Scale/Score (NIHSS)

Widely used, standardized stroke severity score for treatment decisions

Use this tool when

Assessing stroke severity for treatment decisions

Prognosis

Alberta Stroke Program Early CT Score (ASPECTS)

Estimate of infarct burden to guide acute treatment decisions

Use this tool when

Reviewing imaging (CT) before acute stroke treatment

Prognosis

Pittsburgh Response to Endovascular therapy (PRE) Score

Likelihood of good outcome after endovascular LVO treatment

Use this tool when

Determining risk-benefit of endovascular treatment of LVO

Prognosis

HAT (Hemorrhage After Thrombolysis) Score for Predicting Post-tPA Hemorrhage

More rapid post-thrombolytic hemorrhage risk estimate

Use this tool when

Quickly assessing risk-benefit of thrombolytics

Prognosis

SEDAN Score for Post-tPA Hemorrhage

Assessing risk-benefit of thrombolytics with advanced neuroimaging interpretation

Use this tool when

Post-thrombolytic hemorrhage risk estimate with higher specificity