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Stroke care cycle shows potential role for growth MR

Clinical News
van Krieken, Frits, Ph.D. • Netherlands

Stroke care cycle shows potential growth for role of MR

The stroke care cycle traces a patient’s pathway through care, across boundaries in the care system, from prevention and screening to secondary prevention and management of chronic disease.

Care cycle helps to analyze needs and guide improvements in stroke care

“The care cycle approach helps us to detect and deeply understand unmet needs, and expand or improve our solutions,” says Frits van Krieken, PhD, Care Cycle Director of Cardiovascular Disease at Philips Healthcare. “We want to understand the medical process, and also the patient and care provider experiences. We try to avoid ‘jumping to solutions’ until we have validated our understanding.”
 Frits van Krieken, PhD Stroke care cycle
Frits van Krieken, PhD
Stroke care cycle

Care cycle analysis shows what can improve

“The care cycle aligns very well with Philips’ patient-centered approach,” Dr. van Krieken adds. “We look for improvements all through the care cycle, not just to strengthen links that are already strong.”

Philips is currently identifying phases of the stroke care cycle that can be improved. These include:
• Shortening of “discovery-to-needle” times
• Elimination of protocols that require knowing the time of stroke onset, which currently exclude patients who wake up having a stroke
• Giving more patients an opportunity to undergo mechanical clot removal or bleeding treatment in neuro-intervention cath labs
• Rehabilitation support so patients can practice therapies at times and places that are more convenient for them

Potentially increasing role for MR in stroke care cycle

Among clinicians there are different views on the role MR plays at the start of the cycle, in hyperacute diagnosis. Often CT is the preferred modality because it is more readily available and faster. However, MR provides more clinical information to the physician. In sub-acute and follow-up situations MR is a valuable tool to learn more about the stroke itself and assess complications.

“The value of MR after the acute phase has already been recognized, particularly to monitor the effect of treatment or to look for signs of complications,” says Dr. van Krieken. “In the future, MR may be used in the research for the assessment of stroke risk, focusing on carotid artery plaque burden and vulnerability.”

“The quality of MR studies is constantly improving, as is the speed of a complete stroke MR assessment,” says Dr. van Krieken. “I hope its role will expand to making better risk-benefit assessments for therapy, and to guide interventional approaches.”
 DWI ADC Color map of affected area
Color map of affected area

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Nov 24, 2011

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brain infarction, care cycle, stroke

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