Ethical Considerations in Endovascular Thrombectomy for Stroke
Copyright © 2024 Elsevier Inc. All rights reserved..
INTRODUCTION: Stroke is a leading cause of morbidity and mortality globally. Endovascular mechanical thrombectomy is considered for patients with large vessel occlusion stroke presenting up to 24 hours from onset and is being increasingly utilized across diverse clinical contexts. Proactive consideration of distinctive ethical dimensions of endovascular thrombectomy (EVT) can enable stroke care teams to deliver goal-concordant care to appropriately selected patients with stroke but have been underexplored.
METHODS: A narrative review with case examples was conducted.
RESULTS: We explain and critically evaluate the application of foundational bioethical principles and narrative ethics to the practice of EVT, highlight key ethical issues that may emerge in neuroendovascular practice and develop an ethical framework to aid in the responsible use of EVT for people with large-vessel occlusive ischemic stroke.
CONCLUSIONS: EVT for stroke introduces important ethical considerations. Salient challenges include decision-making capacity and informed consent, the telos of EVT, uncertainty, access to care, and resource allocation. An ethical framework focusing on combining patient values and preferences with the best available evidence in the context of a multidisciplinary care team is essential to ensure that the benefits of EVT are responsibly achieved and sustained.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:185 |
|---|---|
| Enthalten in: |
World neurosurgery - 185(2024) vom: 15. Feb., Seite 126-134 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shlobin, Nathan A [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Bioethics |
|---|
| Anmerkungen: |
Date Revised 09.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.wneu.2024.02.047 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368549674 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368549674 | ||
| 003 | DE-627 | ||
| 005 | 20240310231948.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240217s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.wneu.2024.02.047 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1322.xml |
| 035 | |a (DE-627)NLM368549674 | ||
| 035 | |a (NLM)38364896 | ||
| 035 | |a (PII)S1878-8750(24)00244-4 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shlobin, Nathan A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Ethical Considerations in Endovascular Thrombectomy for Stroke |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 09.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: Stroke is a leading cause of morbidity and mortality globally. Endovascular mechanical thrombectomy is considered for patients with large vessel occlusion stroke presenting up to 24 hours from onset and is being increasingly utilized across diverse clinical contexts. Proactive consideration of distinctive ethical dimensions of endovascular thrombectomy (EVT) can enable stroke care teams to deliver goal-concordant care to appropriately selected patients with stroke but have been underexplored | ||
| 520 | |a METHODS: A narrative review with case examples was conducted | ||
| 520 | |a RESULTS: We explain and critically evaluate the application of foundational bioethical principles and narrative ethics to the practice of EVT, highlight key ethical issues that may emerge in neuroendovascular practice and develop an ethical framework to aid in the responsible use of EVT for people with large-vessel occlusive ischemic stroke | ||
| 520 | |a CONCLUSIONS: EVT for stroke introduces important ethical considerations. Salient challenges include decision-making capacity and informed consent, the telos of EVT, uncertainty, access to care, and resource allocation. An ethical framework focusing on combining patient values and preferences with the best available evidence in the context of a multidisciplinary care team is essential to ensure that the benefits of EVT are responsibly achieved and sustained | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Bioethics | |
| 650 | 4 | |a Cerebrovascular accident | |
| 650 | 4 | |a Endovascular | |
| 650 | 4 | |a Ischemic stroke | |
| 650 | 4 | |a Large vessel occlusion | |
| 650 | 4 | |a Mechanical thrombectomy | |
| 650 | 4 | |a Medical ethics | |
| 700 | 1 | |a Regenhardt, Robert W |e verfasserin |4 aut | |
| 700 | 1 | |a Young, Michael J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t World neurosurgery |d 2010 |g 185(2024) vom: 15. Feb., Seite 126-134 |w (DE-627)NLM197924441 |x 1878-8769 |7 nnns |
| 773 | 1 | 8 | |g volume:185 |g year:2024 |g day:15 |g month:02 |g pages:126-134 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.wneu.2024.02.047 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 185 |j 2024 |b 15 |c 02 |h 126-134 | ||