Current Situation and Challenges of Endovascular Treatment Strategies for Acute Ischemic Stroke

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 739

Special Issue Editor


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Guest Editor
Department of Neurosurgery, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, Shimane 693-8555, Japan
Interests: neurosurgery; cerebral aneurysms; acute ischemic stroke; endovascular treatment
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Special Issue Information

Dear Colleagues,

In recent years, endovascular treatments, including thrombectomy for acute ischemic stroke, have made remarkable advancements, contributing to improved patient outcomes. Along with this, there has been a shift in awareness among emergency services and patients, allowing for quicker transportation to facilities capable of providing treatment when stroke symptoms are suspected. Healthcare providers have also been working to establish systems that enable immediate and thorough treatment. However, these efforts are still not sufficient, and various issues remain. In this Special Issue, we will examine the current situation and challenges that lie ahead.

Prof. Dr. Fusao Ikawa
Guest Editor

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Keywords

  • acute ischemic stroke
  • endovascular treatment
  • imaging
  • management of ischemic stroke
  • system and strategy for acute ischemic stroke
  • multidisciplinary approach for acute ischemic stroke

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Published Papers (1 paper)

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Research

12 pages, 1002 KiB  
Article
Improving Acute Ischemic Stroke Care in Kazakhstan: Cross-Sectional Survey
by Shayakhmet Makhanbetkhan, Botagoz Turdaliyeva, Marat Sarshayev, Yerzhan Adilbekov, Sabina Medukhanova, Dimash Davletov, Aiman Maidan and Mynzhylky Berdikhojayev
J. Clin. Med. 2025, 14(7), 2336; https://doi.org/10.3390/jcm14072336 - 28 Mar 2025
Viewed by 510
Abstract
Background: Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide, with upper-middle-income countries (UMICs) facing a disproportionate burden due to systemic inefficiencies in healthcare delivery. Kazakhstan reports the highest global age-standardized mortality rate from ischemic stroke, underscoring the [...] Read more.
Background: Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide, with upper-middle-income countries (UMICs) facing a disproportionate burden due to systemic inefficiencies in healthcare delivery. Kazakhstan reports the highest global age-standardized mortality rate from ischemic stroke, underscoring the need to evaluate current stroke care practices and identify areas for improvement. Objective: This study aimed to assess the current state of acute ischemic stroke care in Kazakhstan by examining key time metrics, protocol adherence, and the utilization of advanced technologies such as artificial intelligence (AI) and telemedicine. Additionally, this study sought to identify regional disparities in care and propose actionable recommendations to improve patient outcomes. Methods: A multi-center cross-sectional survey was conducted across 79 stroke centers in Kazakhstan. Data were collected from 145 healthcare professionals, including neurologists, neurosurgeons, and interventional radiologists, through a validated 23-question online questionnaire. Statistical analysis was performed to identify significant associations between variables. Results: Significant regional disparities were observed in stroke care timelines and technology adoption. Remote and rural areas experienced prolonged prehospital delays, with transport times ranging from 120 to 180 min, contributing to door-to-needle times exceeding the recommended benchmark. Urban centers with higher adoption of AI and telemedicine demonstrated faster treatment initiation and better protocol compliance. Staff training was significantly associated with improved treatment outcomes, with trained centers more likely to implement direct-to-angiography suite protocols, reducing in-hospital delays. Conclusions: Addressing acute ischemic stroke care disparities in Kazakhstan requires a multifaceted approach, including expanding AI and telemedicine, implementing targeted staff training programs, and establishing standardized national stroke protocols. These strategies can help reduce treatment delays, bridge the urban–rural healthcare divide, and improve patient outcomes. The findings have implications for other UMICs facing similar challenges in delivering equitable stroke care. Full article
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