Abstract W P5: “No Turn Back Approach” to Reduce Treatment Time for Endovascular Treatment of Acute Ischemic Stroke
Background: A delay in endovascular treatment is less likely if acute ischemic stroke patients proceed from emergency department(ED) to computed tomographic (CT) scanner and directly to angiographic suite (no turn back approach). We determined the feasibility of the “no turn back approach” and its effect on treatment times and patient outcomes.
Methods: The primary outcomes were procedures performed with a time interval: 1) between ED arrival and microcatheter placement of <120 minutes; and 2) between CT scan acquisition and microcatheter placement of <90 minutes. We determined the affect of the “no turn back approach” on favorable outcome at discharge.
Results: There was a significantly higher rate of CT scan acquisition and microcatheter placement time of <90 minutes in patients in whom “no turn back approach” was used (57.6% versus 31.6%, p=0.0007). There was a significantly higher rate of ED arrival to microcatheter placement time of <120 minutes in patients in whom “no turn back approach” was used (31.8% versus 13.7%, p=0.004). In the exploratory analysis, there was a trend towards higher rate of favorable outcomes (OR 1.6, 95% CI 0.9-2.8, p=0.07) among those treated with “no turn back approach” after adjusting for age, admission National Institutes of Health Stroke Scale (NIHSS) score strata, congestive heart failure and diabetes mellitus.
Conclusions: The “no turn back approach” appeared to be feasible and reduced the time interval between ED arrival and microcatheter placement in acute ischemic stroke patients undergoing endovascular treatment.
Author Disclosures: A.I. Qureshi: None. H. Egila: None. M.M. Adil: None. H. Siddiqi: None. N. Mian: None. A.E. Hassan: None. J.T. Miley: None. G.J. Rodriguez: None. M.K. Suri: None.
- © 2014 by American Heart Association, Inc.