Abstract W P1: Reducing CT-To-Groin puncture Time for Endovascular Treatment of Acute ischemic Stroke: A High Volume Comprehensive Stroke Center Experience
BACKGROUND: One of the key variables that predict a good clinical outcome after endovascular stroke treatment is expeditious reperfusion. We describe a single center experience of process improvement to develop a streamlined Acute Stroke protocol in reducing CT-to-Groin Puncture (CTGP) time for endovascular stroke treatment (EVP) at Erlanger Medical Center.
MATERIAL AND METHODS: All consecutive ischemic stroke patients who received EVP were retrospectively and prospectively registered in the stroke registry. A series of interventions to reduce treatment delays were implemented every year starting in 2012.Starting April 2013 provision for 24/7 in-house attending stroke neurologist presence was initiated. In-hospital delays were analyzed as annual mean/median CTGP time in minutes.
RESULTS: A total of 176 patients were treated EVP between January 2011 to July 2014. The CTGP was reduced annually, from mean 275minutes (median118) in 2011, to 124 minutes (median104) in 2012, to 105 minutes (median99) in 2013 and 78minutes (median69) in 2014 (a 71% decrease in mean from 2011).
There was a significant difference in the CTGP time before and after the initiation of 24/7 in-house attending Stroke neurologist presence. The in-hospital mortality, LOS (length of stay) and sICH (symptomatic ICH) were not adversely affected.
Conclusion: With multiple institution specific interventions, it is possible to improve the treatment times for endovascular stroke treatment even at a high volume non-academic center. The 24/7 in-house stroke neurologist’s presence is feasible and can be justified by expeditious patient selection for endovascular stroke treatment.
The next step will be to show the impact in improving clinical outcome after the successful reperfusion.
Author Disclosures: B.L. Sapkota: None. A. Sirelkhatim: None. N. Pitiyanuvath: None. C. Dellinger: None. T.G. Devlin: None.
- © 2015 by American Heart Association, Inc.