Participants
stroke
STROKE
Our trial population included patients with LVO AIS who presented to the emergency departments of 4 CSCs included in the trial and underwent imaging with CTA. In all 4 CSCs, imaging with noncontrast head CT followed immediately by CTA was performed in all patients presenting as code stroke evaluations throughout the study period as standard of care. Patients were included in the trial if they underwent emergent EVT for treatment of LVO AIS with occlusions of the internal carotid, middle cerebral, anterior cerebral, basilar, intracranial vertebral, or posterior cerebral arteries. Patients were excluded if they presented as in-hospital code stroke alerts or if they were transferred from non–EVT-performing centers to a CSC for EVT evaluation. These patients were excluded as the workflow for these patients is substantially different from the emergency department workflow, which was the primary focus of the intervention. In the case of patients transferred from other hospitals, the decision for EVT is usually made prior to transfer and the patients are brought directly to the angiography suite without repeating imaging. In addition, during the trial period, 2 of the CSCs participated in EVT trials of large core patients. Patients treated with EVT through randomization in one of these trials were also excluded, as these workflows also differed, due to the additional time required in consenting, enrolling and randomizing prior to EVT.