Brain imaging highlighted in 2018 AHA/ASA stroke guidelines

New joint guidelines from the American Heart Association and American Stroke Association (AHA/ASA) may now allow more patients to be eligible for acute ischemic stroke (AIS) procedures and post-treatment medications, including brain-imaging treatment.

A recent article by Cardiovascular Business (CVB) explained that the new guidelines, released Jan. 24 at the AHA’s annual International Conference in Los Angeles, were created by researchers who analyzed more than 400 peer reviewed studies. The new set of guidelines was published in Stroke the same day.

“Just a few years ago, stroke dropped from the nation’s number four killer to number five, yet it still kills more than 130,000 people every year,” told guideline writing chair William Powers, MD to AHA/ASA. “That’s why the AHA/ASA hasn’t rested in its determination to treat and beat stroke - and that’s why today we released new acute ischemic stroke treatment guidelines.”

The recommendations are 65 pages in total, however Power said that “an extended window for thrombectomies” and “expanded eligibility for alteplase” are the most important.

The tissue plasminogen activator alteplase, a common stroke medication and the only clot-dissolving treatment approved by the FDA for ischemic stroke patients, is recommended for major stroke patients and some minor stroke patients (depending on if the stroke event happened soon enough to administer), according to CVB. In regards to brain imaging, the new guidelines state that alteplase and mechanical thrombectomy must be timely administered and not all patients have access to both, however both can produce very positive results.

“The board suggested a 20-minute limit for performing brain imaging on stroke patients after their arrival at the ER,” explained CVB. “The imaging can aid initial evaluations and help determine which patients are suited for which treatments.”