![]() New South Wales is the most populous state and has four CSCs which provide 24/7 EVT service to all local health districts and specialty networks. To achieve an adequate EVT case load and scalability, Australia has centralised CSCs to major cities. 8 Treatment at high-volume centres is associated with improved functional outcome and lower mortality. Delivery of EVT is complex and resource-intensive. ![]() There is significant variation in the density of cities and remote areas. It is the earth’s sixth largest land mass and has the lowest population density in the world. The current Australian model of stroke care expedites medical assessment and provides ready access to IVT at PSCs but requires transfer of patients eligible for EVT to a CSC.Īustralia has a unique geography. 7 Comprehensive stroke centres (CSC) are large tertiary referral centres that have onsite 24-hour access to neurology, critical care and neurointerventional expertise, and provide additional specialised acute stroke services including EVT and neurosurgery. Primary stroke centres (PSC) are hospitals distributed across metropolitan and regional communities that offer dedicated stroke services, including intravenous thrombolysis (IVT) and stroke unit care. 4 5 Shorter stroke onset to groin puncture time (defined as the start of treatment) and reperfusion has been associated with improved functional outcome. Multicentre, randomised controlled trials have demonstrated the safety and efficacy of this procedure within 6 hours 1–3 and in selected patients up to 24 hours from stroke onset according to advanced imaging findings. Endovascular thrombectomy (EVT) is the standard of care for patients with acute ischaemic stroke (AIS) with large vessel occlusion (LVO) in the anterior cerebral circulation (ACC).
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