Additional information

Recommendation 1.3.2

The committee felt that 'immediately' is defined as 'ideally the next slot and definitely within 1 hour, whichever is sooner'.

Recommendations 1.4.5 to 1.4.7

In May 2019, not all devices with a CE mark for thrombectomy were intended by the manufacturer for use as recommended here. The healthcare professional should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. Medicines and Healthcare products Regulatory Agency (MHRA) advice remains to use CE‑marked devices for their intended purpose where possible. See MHRA's guidance on off-label use of a medical device for further information.

Recommendation 1.4.12

There may be a subgroup of people for whom the risk of venous thromboembolism outweighs the risk of haemorrhagic transformation. People considered to be at particularly high risk of venous thromboembolism include anyone with complete paralysis of the leg, a previous history of venous thromboembolism, dehydration or comorbidities (such as malignant disease), or who is a current or recent smoker. Such people should be kept under regular review if they are given prophylactic anticoagulation.

Recommendation 1.4.15

There was insufficient evidence to support any recommendation on the safety and efficacy of anticoagulants versus antiplatelets for the treatment of people with acute ischaemic stroke associated with antiphospholipid syndrome.

Recommendation 1.4.21

The consensus of the committee is that it would be safe to start statins after 48 hours.

  • National Institute for Health and Care Excellence (NICE)