The Endovascular Reperfusion Alberta (ERA) project is a provincial strategy for increasing access to Endovascular Therapy (EVT) for patients with acute ischemic stroke. Endovascular therapy is a stroke treatment that removes large stroke-causing clots from the brain and substantially improves the chance for a better outcome for eligible patients.
“Endovascular treatment for large artery ischemic stroke has clearly demonstrated efficacy with numbers needed to treat of approximately four to achieve functional independence at 90 days. This therapy has profound impact on patients who suffer the most devastating ischemic strokes; patients who, if left untreated, will place a more significant burden on the healthcare system and family caregivers.”
Canadian Best Practice Recommendations for Stroke Care
Heart and Stroke Foundation of Canada
In Alberta, EVT is only available in Calgary (Foothills Medical Centre) and Edmonton (University of Alberta Hospital). Our health care system must adapt to ensure the timeliness and accessibility of this procedure for all Albertans. The Cardiovascular Health and Stroke Strategic Clinical Network has undertaken the Endovascular Reperfusion Alberta (ERA) project to increase access to endovascular therapy for patients with acute ischemic stroke.
Our system of early stroke care is being revised to make endovascular therapy accessible to those who would benefit. This revision includes:
The QuICR Initiative has paved the way for improving processes at primary stroke centres and comprehensive stroke centres in Alberta.
Research in Alberta showed that for those people who sustained a large stroke and received EVT therapy, almost twice as many returned to functional independence and only half as many died, compared to those who did not receive the treatment. Our goal is to achieve similar positive outcomes for the approximately 400 Albertans who are eligible every year.
The Cardiovascular Health and Stroke Strategic Clinical Network is working with stakeholders from across the province, including QuICR, EMS, STARS, Emergency Medicine, Zone Stroke Programs Administration, Stroke Neurology, the Emergency Strategic Clinical Network, Primary Stroke Centres, RAAPID, and Diagnostic Imaging, to adapt our stroke system of care to facilitate patients’ access to endovascular therapy. This project aligns with quality improvement work being undertaken by Alberta stroke researchers.
Endovascular therapy works
In the ESCAPE Trial, overall mortality for patients receiving EVT was reduced by half, and overall positive outcomes increased from 30% to 55%.
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