Survey questions with responses (bold), followed by per cent of the total
| Question | Responses | |||||
|---|---|---|---|---|---|---|
| 1. Where do you practice? | NE US 23.1% | SE US 26.9% | MW US 25.6% | NW US 5.1% | SW US 16.7% | Other 2.8% |
| 2. What type of institution do you practice at? | Academic 68.0% | Private 30.8% | Other 1.3% | |||
| 3. How many other stroke centers exist within your state? | 0 5.1% | 1–2 7.7% | 3–4 24.4% | 5–9 21.8% | 10 or more 41.0% | |
| 4. Before January 1, on average my practice would perform (thrombectomies per month) | >10 15.4% | 6–10 15.4% | 1–5 66.7% | 0 2.6% | ||
| 5. Since January 1, on average my practice performs (thrombectomies per month) | >10 31.2% | 6–10 31.2% | 1–5 37.7% | 0 0.0% | ||
| 6. Since January 1, the number of inpatient consultations for possible thrombectomy has | Greatly increased (double or higher) 23.1% | Slightly increased (more but not doubled) 50.0% | Stayed constant 26.9% | Slightly decreased (less but not halved) 0.0% | Greatly decreased (more than halved) 0.0% | |
| 7. Since January 1, the number of hospital–hospital transfers for possible thrombectomy has | Greatly increased (double or higher) 26.9% | Slightly increased (more but not doubled) 52.6% | Stayed constant 18.0% | Slightly decreased (less but not halved) 2.6% | Greatly decreased (more than halved) 0.0% | |
| 8. Comparing your current practice to the last year, you are performing angiography and thrombectomy on patients with less severe strokes based on NIHSS | True 46.2% | False 53.9% | ||||
| 9. Comparing your current practice to last year, you are performing angiography and thrombectomy on patients that are of older age | True 56.4% | False 43.6% | ||||
| 10. Comparing your current practice to last year, you are performing angiography and thrombectomy on patients with less favorable CT or perfusion imaging | True 17.1% | False 82.9% | ||||
| 11. Comparing your current practice to last year, you are performing angiography and thrombectomy on patients with longer times from onset to presentation | True 39.7% | False 60.3% | ||||
| 12. Comparing your current practice to last year, my current practice's overall threshold in pursuing mechanical thrombectomy based on selection criteria (NIHSS, age, imaging criteria, time) is | Much more aggressive 16.7% | Slightly more aggressive 48.7% | Unchanged 33.3% | Slightly less aggressive 1.3% | Much less aggressive 0.0% | |
| 13. When considering patients for thrombectomy, our practice is to use (select the most common strategy) | Non-contrast head CT only 0.0% | CT and CT angiography without perfusion imaging 55.1% | CT and CT angiography with perfusion imaging 37.2% | MRI and/or MRA 7.7% | ||
| 14. What is the dominant imaging criteria you use when selecting patients for mechanical thrombectomy | ASPECTS score 23.1% | <1/3 of MCA territory infarction 9.0% | Collateral score 1.3% | Perfusion imaging changes 11.5% | We use a combination of 2 or more of these 55.1% | |
| 15. When considering patients for mechanical thrombectomy, which of the following best summarizes your current practice patterns | Patients are only candidates if NIHSS is ≥8 9.0% | We may perform thrombectomy in rare cases when NIHSS is <8 60.3% | We frequently perform thrombectomy when NIHSS is <8 26.9% | We frequently perform thrombectomy when any deficits are present (NIHSS 1 or higher) 3.9% | ||
| 16. When considering patients for mechanical thrombectomy, which of the following best summarizes your current practice patterns | Patients are only candidates if they present within 6 h from onset 9.0% | We may perform thrombectomy in rare cases when time is >6 h 35.9% | We frequently perform thrombectomy when time is >6 h 14.1% | We perform thrombectomy regardless of time course if imaging is favorable 41.0% | ||
| 17. For an intracranial ELVO, our practice patterns are to begin thrombectomy with | Retrievable stent without balloon guide or aspiration 5.1% | Retrievable stent with balloon guide or aspiration 23.1% | Retrievable stent with aspiration at clot (Solumbra) 28.2% | ADAPT technique 39.7% | Intra-arterial thrombolytic or other 3.8% | |
| 18. What is your predominant type of anesthesia you use during acute thrombectomy procedures? | General anesthesia 20.5% | Conscious sedation 56.4% | None or minimal sedation 23.1% | |||
| 19. In what percentage of your thrombectomy procedures do you use adjunctive intra-arterial medications like tPA or abciximab? | 0–25% 91.0% | 26–50% 7.7% | 51–75% 0.0% | 76–100% 1.3% | ||
| 20. How successful are you with your primary thrombectomy technique (TICI 2b revascularization with 3 passes or less, or before switching to a different technique)? | 0–50% 0.0% | 50–70% 25.6% | 70–90% 44.9% | >90% 29.5% | ||
| 21. In what percentage of patients do you achieve a final TICI 2b or greater revascularization? | 0–25% 0.0% | 26–50% 2.6% | 51–75% 16.7% | 76–100% 80% | ||
ADAPT, A Direct Aspiration First Pass Technique; ASPECTS, Alberta Stroke Program Early CT Score; ELVO, emergent large vessel occlusion; NIHSS, National Institutes of Health Stroke Scale; MCA, middle cerebral artery; MW, midwest; MRA, MR angiography; NE, northeast; NW, northwest; SE, southeast; SW, southwest; TICI, Thrombolysis in Cerebral Infarction; tPA, tissue plasminogen activator.