Factors Associated with Patient Recall and Lived Experiences in the Peri-operative Endovascular Thrombectomy Period: A Narrative Review

Abstract

Introduction- Little is known about patients’ large vessel occlusion stroke experience with the onset of symptoms and subsequent treatment by endovascular thrombectomy. This narrative review aims to synthesize the current literature and expose existing gaps.

Methods- A narrative literature review guided by a physiological lens of impaired tissue perfusion was conducted to identify research exploring patients’ peri-procedural experiences during EVT. Articles published between 2013-2023 were collected using CINAHL, PubMed, and Scopus search engines.

Results- The literature search yielded 680 articles that were screened and reduced to 6 publications deemed eligible for review. The findings illustrated a literature deficit in patient perspectives regarding endovascular thrombectomy for large vessel occlusion stroke. Peri-procedural recall for other conditions has been investigated, revealing that it is a multifactorial experience for each patient and dependent on whether conscious sedation or general anesthesia is used. Moreover, a qualitative approach for other acute diagnoses highlighted that hidden or unexpected experiences can be revealed when the patient’s voice is captured. The caregiver endovascular thrombectomy pathway has been explored and may parallel the emotions and needs experienced by patients. Research has shown that acute stress symptoms are observed following a stroke event for patients and caregivers, leading to potential long-term psychological complications.

Conclusion- Current literature exploring endovascular thrombectomy for large vessel occlusion stroke is empirically focused, lacking the patient’s voice in lived experience. Future work using a multimethod approach is warranted.