Endovascular clot retrieval for acute stroke: statewide service protocol

Please note that this guidance will be reviewed by Safer Care Victoria periodically to ensure the content is up to date. In the meantime, we recommend that you also refer to more contemporaneous evidence where possible.

EVT is a highly specialised procedure only available at a limited number of tertiary hospitals. It is technically challenging, performed by highly trained radiologists, neurologists or neurosurgeons who have specialist skills in neurointervention.

EVT requires a well-organised system to identify suitable candidates for therapy and, if they are not already at an EVT-capable centre, rapidly transport them to one. 

A new service protocol for Victoria

In 2017, approximately 345 Victorians underwent EVT as a result of having an ischaemic stroke. New evidence published in 2018 has revised the treatment window for ECR. Therefore, we have updated this statewide service protocol to help health services identify patients suitable for EVT, and ensure they are promptly transferred and treated. Key clinical changes within this protocol include: 

• Number of EVT management centres in Victoria
• Intravenous thrombolytic administration timeframe consideration following stroke onset
• Initial Ambulance Victoria responses for patients suspected stroke
• Brain imaging recommendation for patients with suspected stroke
• Guidelines for EVT eligibility.

Download the updated protocol >

Helping your patients understand ECR

Our patient fact sheets are designed for you to adapt to your health service.

You can use them when talking to patients who have just experienced a stroke and their families, as they help explain the benefits and risks of EVT. 

There are 2 versions for:

• patients who present to an ECR capable centre
• patients who require transfer to an ECR centre. This information sheet explains the need and purpose of transfer to an ECR-capable centre in order to be assessed for this procedure.