New AHA stroke guidelines reinforce McLaren Stroke Network practice; support thrombectomy up to 24 hours

A “sweeping change” in the treatment and management of acute stroke was recently announced by the American Heart Association/American Stroke Association at the International Stroke Conference in Los Angeles.

These new guidelines include evidence supporting that patients can benefit from a thrombectomy for up to 24 hours and still achieve enhanced, 1A outcomes. Previous guidelines suggested six hours.

With the proficiency of the McLaren Stroke Network, interventional neurologists at McLaren have been in the practice of performing thrombectomies on acute stroke patients up to 24 hours, achieving those same enhanced outcomes before the change in guidelines was initiated.

“These updated guidelines are in line with what we have been experiencing with our thrombectomy patients, in that we have been seeing good outcomes even after six hours using our McLaren protocols,” said Aniel Majjhoo, M.D., interventional neurologist and medical director of the McLaren Stroke Network. “To have the updated industry guidelines confirm our standard care practice adds further credibility to our practice,” added Dr. Majjhoo, who attended the conference and was in the audience when the new guidelines were announced.

The revised guidelines were published in Stroke, the peer-reviewed medical journal of the American Heart Association.

To achieve a 1A recommendation, guidelines need to be supported by evidence from multiple randomized control trials.

The DAWN study, which was published in the New England Journal of Medicine, found enhanced outcomes from thrombectomies up to 24 hours. Additionally, DEFUSE-3, the study announced at the conference and also published in the New England Journal of Medicine, supported patient outcomes after thrombectomies up to 16 hours. The number needed to treat for a good outcome is two.