Nederlands onderzoek zet behandeling herseninfarct op zijn kop

Recent randomised clinical trials have convincingly shown that endovascular therapy with the use of a retrievable stent considerably improves the chance of a good outcome in selected patients with acute ischaemic stroke and an occlusion of a proximal intracranial artery in the anterior circulation. The benefit of treatment strongly increases with shorter delays to reperfusion. This has major implications for the organisation of stroke care in the Netherlands. Agreements between all relevant parties are required in each region regarding the rapid referral of eligible patients to intervention centres. CT angiography must now become part of the standard evaluation of all patients with suspected ischaemic stroke presenting within six hours of symptom onset in order to achieve appropriate patient selection. Attention should be paid to workflow efficiencies to reduce delays. Since only a small proportion of stroke patients is eligible for endovascular therapy, the development of additional stroke therapies remains essential.

Conflict of interest and financial support: the author is financially supported by a grant from the Dutch Heart Foundation (Nederlandse Hartstichting, grant no. 2010T075). an ICMJE form provided by the author is available online along with the full text of this article.