Systems should be designed, executed, and monitored to emphasize expeditious assessment and treatment. Outcomes for all patients should be tracked. Facilities are encouraged to consider preestablished criteria that can be used to credential individuals who can perform safe and timely intra-arterial revascularization procedures such as those agreed on by the Committee for Advanced Subspecialty Training of the Society of Neurological Surgeons in conjunction with other professional societies.61a I C-EO Recommendation reworded for clarity from 2015 Endovascular. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. It may be useful for primary stroke centers and other healthcare facilities that provide initial emergency care, including administration of IV alteplase, to develop the capability of performing emergency noninvasive intracranial vascular imaging to most appropriately select patients for transfer for mechanical thrombectomy and to reduce the time to mechanical thrombectomy. IIb C-LD Recommendation reworded for clarity from 2015 Endovascular. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Between 2006 and 2010, the proportion of ischemic strokes undergoing computed tomographic angiography (CTA) increased from 3.8% to 9.1% (P<0.0001). Computed tomography perfusion (CTP) increased from 0.05% to 2.9% over the same period (P<0.0001). Reperfusion treatment was more common among those who were imaged with CTA (13.0%) and CTP (17.6%) compared with those with computed tomography (CT) of the head alone (4.0%; P<0.0001).62 However, when considering implementation of multimodal CT imaging at small or remote-access hospitals, resource availability and realistic expectations for gains in efficiency should be taken into account. 1.6. 