Abstract NS11: An Integrated Biplane Angiosuite Within The NICU Reduces Time From CT Imaging To Groin Puncture.
INTRODUCTION: Time delays to reperfusion in endovascular therapy for acute ischemic stroke (AIS) are multifactorial. We investigated a prototypical NICU design, consisting of an angiosuite and CT scanner within the same unit, to determine its impact on CT to groin puncture (GP) times. Patients arriving from outside hospitals (OSH) directly to the NICU were compared to patients who went through our local Emergency Department (ED).
METHODS: We conducted a retrospective analysis of 230 patients from a prospectively maintained database from October 2010- June 2012 who underwent endovascular therapy for AIS. A univariate analysis was performed comparing patient characteristics between the two populations to identify differences in time intervals from CT imaging to GP.
RESULTS: Of the 195 patients included in the analysis, 125 (64%) patients were from OSH. The patient characteristics in both groups were similar, with the exception of lower rates of hypertension (67% vs 81%; p<0.02), longer times intervals from last known normal to GP (median 310 mins vs. median 221 mins; p <0.01), and lower pre-treatment ASPECTS (48% <8 vs. 25% <8; p <0.01) among OSH patients. Patients transferred from OSH had significantly lower times from in-house CT to GP as compared to patients from the ED (44.2 +/- 33 mins vs. 114 +/- 58 mins; p<0.01). Despite an increased number of non-contiguous multimodal imaging studies performed on ED patients compared to those from OSH (37% vs 5%; p<0.01), exclusion of these patients still resulted in a significant reduction in time from CT to GP (41.9+/- 27 mins vs. 95.8+/-40.3 mins; p<0.01) among OSH transfers.
CONCLUSIONS: The integration of a biplane angiosuite within the NICU reduces the times from CT imaging to GP, thereby lowering the times to reperfusion, and hopefully, patient outcomes.
- © 2012 by American Heart Association, Inc.