Identified Common Data Elements
Patient characteristics (13)Age at procedure characteristicsWeight (kg)
GenderLiving Status
RaceZip/Postal Code
Primary InsurerAmbulatory Status
Height (inches)Smoking
Height (cm)Quit Smoking Date
Weight (lbs)
Medical History (14)Chronic obstructive pulmonary diseasePrior Coronary Artery Bypass Graft
DiabetesPrior Percutaneous Coronary Intervention
DialysisPrior Carotid Endarterectomy/Carotid Artery Stenting
HypertensionMajor surgery
Atrial FibrillationMajor Brain surgery
HyperlipidemiaMajor cardiac Procedure Characteristics
Prior Congestive Heart FailureMajor vascular Procedure Characteristics
Pre-Procedural Characteristics (36)Admit DateTime at IV tPA Given
Visit CodeOther IV Thrombolytic Given
Transferred From?Time at other IV Thrombolytic
CAD SymptomsPre-Stroke Modified Rankin Score (mRS)
Prior Stroke EventNational Institute of Health Stroke Score
Pre-op Haemoglobin (g/dl)CT Angiography
Pre-op Haemoglobin (g/L)MRI
Creatinine (mg/dl)CT Perfusion
Creatinine (umol/L)Magnetic Resonance Perfusion
Blood Pressure On Arrival - SystolicCT
DiastolicAlberta Stroke Programme Early CT Score
International Normalised RatioCore Infarct Volume (DWI Volume)
GlucoseStroke Onset Witnessed
Pre-Op American Society of Anesthesiologists Physical Status ClassificationTime Last Known Well
Pre-Op P2Y12 AntagonistTime at First Emergency Department Arrival
Pre-Op StatinTime at Second ED Arrival
Pre-Op Chronic AnticoagulantTime at Most Recent Imaging Done
IV Tissue Plasminogen Activator (tPA) GivenTime at Image Interpretation
Procedure Characteristics (102)Procedure Characteristics DateFinal Pass Stent Ret Dia
Primary PhysicianPass 1 Stent Ret Len
AssistantPass 2 Stent Ret Len
Medicare Health Insurance Claim NumberFinal Pass Stent Ret Len
Hypercoagulable StatePass 1 Asp Catheter
IpsilateralPass 2 Asp Catheter
ContralateralFinal Pass Asp Catheter
Initial Location of OcclusionPass 1 Asp Cath Other
Side of OcclusionPass 2 Asp Cath Other
Location of Additional OcclusionFinal Pass Asp Cath Other
Side of Additional OcclusionPass 1 Separator Used
Expanded Thrombolysis In Cerebral Infarction GradePass 2 Separator Used
Trial EnrollmentFinal Pass Separator Used
American Society of Anesthesiologists ClassPass 1 Asp Type
AnaesthesiaPass 2 Asp Type
Intubated Prior to Angio Suite ArrivalFinal Pass Asp Type
Time at Arrival to Angio SuiteAdditional Treatment
Time at Groin PunctureExtra Cranial Angioplasty
Stroke Onset to Groin PunctureSide of Extra Cranial Angioplasty
ED Arrival to Groin PunctureExtra Cranial Stent
Number of PassesSide of Extra Cranial Stent
Pass 1 Intervention TypeIntra-arterial Thrombolytic Given
Pass 2 Intervention TypeThrombolytic Dosage
Final Pass Intervention TypeIIb/IIIa Inhibitor Given
Pass 1 Clot LocationHeparin Given
Pass 2 Clot LocationTotal Heparin Units
Final Pass Clot LocationActivated Clotting Time
Pass 1 Guide Cath BalloonAngiomax Given
Pass 2 Guide Cath BalloonASA Given Intra-procedurally
Final Pass Guide Cath BalloonASA Dosage
Pass 1 Guide Cath AspRoute
Pass 2 Guide Cath AspP2Y12 Antagonist Given
Final Pass Guide Cath AspP2Y12 Antagonist Dosage
Pass 1 Inter Cath AspOther intraarterial medication (antispasm)
Pass 2 Inter Cath AspRoute
Final Pass Inter Cath AspTotal Fluoro Time
Pass 1 Inter Cath UsedTotal Radiation
Pass 2 Inter Cath UsedContrast Volume
Final Pass Inter Cath UsedFinal eTICI Grade
Pass 1 Int Cath Other:Time at Recanalisation
Pass 2 Int Cath Other:Intra-Procedural Complication
Final Pass Int Cath Other:Embolization to Non-target Vessel
Pass 1 Distal Dev Trtmt AppLocation of Vessel Perforation
Pass 2 Distal Dev Trtmt AppRequired Additional Treatment
Final Pass Distal Dev Trtmt AppTechnical Failure
Pass 1 DD Treat App OtherPlease Specify:
Pass 2 DD Treat App OtherProcedure Characteristics Time
Final Pass DD Treat App OtherTime to Recanalisation
Pass 1 Stent RetrieverAccess artery issues and complications (including but not limited to)
Pass 2 Stent RetrieverDissection
Final Pass Stent RetrieverOcclusion
Pass 1 Stent Rtrvr OtherDevice issues:
Pass 2 Stent Rtrvr OtherDissection
Final Pass Stent Rtrvr OtherDevice failure, breakage, or foreign body embolization
Pass 1 Stent Ret DiaDevice related emboli
Pass 2 Stent Ret DiaVessel perforation/rupture/extravasation (intracranial)
Post-Procedural Characteristics (29)Haemorrhagic Infarction (HI) 1Groin Puncture Complication Requiring Intervention
HI2Time Point of Occurrence
Parenchymal hematoma (PH) 1 Type Haemorrhagic TransformationCheck All That Apply:
PH2 Type Haemorrhagic TransformationFinal Infarct Volume defined using imaging type and timepoint
Parenchymal hematoma remote from infarcted brain tissueFinal Infarct Volume NA
Intraventricular haemorrhageIntensive Care Unit Stay
Subarachnoid haemorrhageDischarge NIHSS
Subdural haemorrhageDischarge NIHSS NA
Please Specify:NIHSS Score Change (Timepoint - Pre-Stroke) >= 4
Discharge DateSuspected Cause of Neurologic Deterioration
Discharge StatusNeed for access site arterial repair
Date of DeathArtery Type
Post-Operative Length of StayType of complication
Alive at 24 Hours?Subsequent complications
24 Hour National Institute of Health Stroke ScoreRetroperitoneal haemorrhage
24 Hour CT
Imaging Data (3)All Head and Neck CT /CT Angiography/CT PerfusionAll cerebral angiography - Digital Subtraction Angiography
All head and Neck Magnetic Resonance- MRI/ Angiography/ Perfusion-weighted MRI
Follow-Up (26)Date of Contact1 Year NIHSS
Contact ByRe-admission within 1 year
Current Living Status; (Rehab, Nursing Facility, Hospice, Home, Dead)Antiplatelet or Dual Antiplatelet Therapy type and duration of therapy
Date of DeathCerebral target (treated) vessel re-occlusion
Cause of DeathDeath within 90 days
Current SmokingDeath within 1 year
30 Day Modified Rankin ScoreNew cerebral infarct within 30 days
30 Day National Institute of Health Stroke ScoreNew cerebral infarct within 90 days
Re-admission within 30 daysNew cerebral infarct within 1 year
90 Day mRSDischarge Disposition; (Rehab, Nursing Facility, Hospice, Home)
90 Day NIHSSmRS 2 years
Re-admission within 90 daysmRS 3 years
1 Year mRSmRS 5 years