These previous publications and their abbreviations used in this document are listed in Table 2. Existing recommendations that are unchanged are reiterated with reference to the previous publication. New or revised recommendations that supersede previous guideline recommendations are accompanied by 250-word knowledge bytes and data supplement tables summarizing the key studies supporting the recommendations in place of extensive text. These guidelines use the American College of Cardiology (ACC)/AHA 2015 Class of Recommendations (COR) and Levels of Evidence (LOE) ( Table 1) and the new AHA guidelines format. The systematic reviews “Accuracy of Prediction Instruments for Diagnosing Large Vessel Occlusion in Individuals With Suspected Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke” 3 and “Effect of Dysphagia Screening Strategies on Clinical Outcomes After Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke” 4 are published in conjunction with this guideline. 2Īn independent evidence review committee was commissioned to perform a systematic review of a limited number of clinical questions identified in conjunction with the writing group, the results of which were considered by the writing group for incorporation into this guideline. We have not included recommendations for cerebral venous sinus thrombosis because they were covered in a 2011 scientific statement and there is no new evidence that would change those conclusions. We have restricted our recommendations to adults and to secondary prevention measures that are appropriately instituted within the first 2 weeks. These guidelines address prehospital care, urgent and emergency evaluation and treatment with intravenous (IV) and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are often begun during the initial hospitalization. The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations for clinicians caring for adult patients with acute arterial ischemic stroke in a single document. 1 Much of this new evidence has been incorporated into American Heart Association (AHA) focused updates, guidelines, or scientific statements on specific topics relating to the management of patients with AIS since 2013. New high-quality evidence has produced major changes in the evidence-based treatment of patients with acute ischemic stroke (AIS) since the publication of the most recent “Guidelines for the Early Management of Patients With Acute Ischemic Stroke” in 2013. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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