CVA interventions and timeline? What type of window of time are you seeing..........?

[nicki22]

From the last known normal we start the clock and decide which options are available for acute CVAs. The facility I'm employed by doesn't have the capabilities to evacuate cerebral clots. We provide tPa, anticoagulants, and anti platelets. I want to know what the window of time is for vascular interventions. Are there factors that may lengthen the window in circumstances. Please fill me in. Thanks

[hodgieRN]

MERCI procedures are great! It can be used past the 3 hr window if criteria is met. If I recall correctly, I believe it can be within 6 hrs from time of onset. And I think some studies are saying it can be up to 8 or maybe more? Something along those lines. I can find out next time I am am work. But as the hour number increases, the risk for re-perfusion injury/bleeding increases.

There can be some circumstances where a MERCI is done as a Hail Mary. For example, if someone has a massive basal ganglia CVA that will result in being locked-in or being in a persistent vegetative state, it could extend the window. It's risky, but at that point, the pt has no chance of anything. The pt could have risk for hemorrhaging or even death, but the radiologist will have to determine if the benefit lies past the window. This is basically it when considering a window extension until further studies suggest otherwise. Hope this helps