Abstract T P6: Mobile Endovascular-therapy Team is Alternative System to Patient Transfer for Acute Ischemic Stroke
Background and Purpose: Stroke centers which can provide endovascular therapy (EVT) for acute ischemic stroke patients are limited. Patients who considered eligible for EVT need to be transferred to hospitals where EVT available. However, delays for interhospital transfers may reduce the opportunity for good outcomes. Besides we accepted patients from outside hospitals, we formed a neurointerventional team which called “Mobile EVT Team (MET)” to offer EVT at outside hospitals. In this study, we compare elapsed time until the beginning of EVT between patients who performed EVT at outside hospitals and who received EVT in our hospital after they were transferred.
Methods: From July 2012 to June 2014, acute ischemic stroke patients who performed EVT by MET (MET group) and received EVT after they were transferred to our hospital (transfer group) were enrolled. We defined the beginning of EVT as the time of injection from guiding catheter for EVT. In MET group, if guiding catheter was indwelled before MET arrival, the beginning of EVT was defined the time of MET arrival. We compared the time from initial imaging to the beginning of EVT (“picture to treatment” time) among two groups.
Results: Thirty Patients from one site (distance between hospitals: 16 miles) in MET group and 7 patients from three sites (distance between hospitals: 0.5, 1 and 3 miles) in transfer group were analyzed. There was no difference the frequency of intravenous thrombolysis therapy among two groups. In MET group, time from notification to MET arrival was 72 minutes (interquartile range [IQR], 60-81). In transfer group, time from notification to patient arrival and from patient arrival to groin puncture were 55 minutes (IQR, 50-72) and 36 minutes (25-39). Picture to groin puncture time (MET group vs. transfer group: 68minutes [54-81] vs. 139 minutes [127-217], p=0.0004), picture to treatment time (122 minutes [106-165] vs. 168 minutes [154-241], p=0.0105) and notification to treatment time (90 minutes [78-116] vs. 125 minutes [109-140], p=0.0099) were significantly shorter in MET group than in transfer group.
Conclusions: MET can provide EVT at outside hospitals without time delay and can be alternative system to patient transfer.
Author Disclosures: T. Amano: None. M. Sato: None. Y. Matsumaru: None. T. Ota: None.
- © 2015 by American Heart Association, Inc.