IAT selection criteria for anterior circulation strokes at Massachusetts General Hospital
| Likely to benefit (meets all criteria) | Unlikely to benefit (meets one criterion) | |
|---|---|---|
| Clinical criteria | ||
| NIHSS | ≥8 | <4 |
| Time, h* | ≤6 | >8 |
| Age, years | <80 | >90 |
| Premorbid state | mRS ≤1, life expectancy >12 months | mRS ≥4, life expectancy <6 months, severe dementia |
| Imaging criteria | ||
| Infarct size | DWI <70 cm3, ASPECTS >7 | DWI >100cm3, ASPECTS <5 |
| Arterial occlusion | ICA, M1, proximal M2 | Distal M2, A2 or beyond |
All cases likely to benefit are taken to IAT; cases unlikely to benefit are not offered treatment. Remaining patients are considered uncertain to benefit and determination of IAT candidacy is made on a case-by-case basis.
*Time from last seen well to imaging selection.
A, anterior cerebral artery; ASPECTS, Alberta Stroke Program Early CT Score; DWI, diffusion-weighted imaging; IAT, intra-arterial therapy; ICA, internal carotid artery; M, middle cerebral artery; mRS, modified Rankin Score; NIHSS, NIH Stroke Scale.