LAUSR

We read with interest, the article by Boulouis et al,1 “Immediate vascular imaging needed for efficient triage of patients with acute ischemic stroke initially admitted to nonthrombectomy centers.” We are concerned with the policies advocated by the authors because they reinforce an intuitive finding that patients with National Institutes of Health Stroke Scale scores >8 and pretransfer vascular imaging are more likely to undergo endovascular thrombectomy. Given the trajectory of modern research in endovascular thrombectomy to include, rather than exclude, more patients, we are unsure how these results are to influence current practice. A policy requiring pretransfer vascular imaging only provides a means for inefficient triage and unnecessary delay in an era where time is brain. The majority of patients referred from nonthrombectomy centers undergo …