Recent randomized controlled trials have demonstrated the superiority of endovascular treatment (ET) over medical management in the treatment of acute ischemic stroke patients with anterior circulation emergent large vessel occlusions (ELVOs). Due to such accumulating evidence, expanding ET has become of paramount importance. Advancements in modern technology have enabled the use of mobile stroke units, telestroke networks, mobile neuroendovascular teams, and smartphone applications that shorten the time window to treatment and, thus, make patients more amenable to ET. Additionally, modifying stroke-screening tools to make them more accessible to first responders and the creation of stroke registries can provide further opportunities for ET.
Keywords: CPSSS = Cincinnati Prehospital Stroke Severity Scale; ELVO = emergent large vessel occulion; EMS; EMS = emergency medical services; ET = endovascular treatment; FAST-ED = Field Assessment Stroke Triage for Emergency Destination; KMET = Kanazawa mobile embolectomy team; MSU = mobile stroke unit; NIHSS = National Institutes of Health Stroke Scale; PASS = Prehospital Acute Stroke Severity; RACE = Rapid Arterial Occlusion Evaluation; VAN = Vision, Aphasia, Neglect; acute stroke; emergent large vessel occlusion; endovascular treatment; mechanical thrombectomy; mobile stroke unit; prehospital stroke scale; tPA = tissue plasminogen activator; telestroke.