This article is more than 5 years old. Information may no longer be current.
Direct transfer to ‘angio-suite’ decreased stroke treatment time
Click Here to Manage Email Alerts
Bypassing the ED and directly transferring patients with acute stroke to an angiography procedure room, or an “angio-suite,” may shorten time to endovascular treatment, researchers reported at the International Stroke Conference.
In the study, Marc Ribo, MD, PhD, of the Stroke Unit, Hospital Vall d'Hebron in Barcelona, and colleagues found that median time from admission to start of the procedure was considerably shorter for direct transfer patients vs. those who went to the ED first (15 vs. 65 minutes; P < .01). Average endovascular treatment time was also shorter for direct transfer patients vs. those receiving standard of care (36 vs. 55 minutes; P = .034), as was median total time from admission to recanalization (52 vs. 123 minutes; P < .01).
Treatment outcomes were similar among patients directly transferred compared with those who visited the ED, with results indicating comparable rates of symptomatic intracranial hemorrhage (6.7% vs. 6.6%; P = .98) and 24-hour NIH Stroke Scale score (10 vs. 10.5; P = .81). Rates of recanalization, defined as Thrombolysis in Cerebral Infarction (TICI) score of 2b or 3, were 86% and 81% for the direct transfer group and the standard of care group, respectively (P = .24).
The study included patients with pre-hospital stroke code activation admitted within 4.5 hours from symptom onset. Sixteen patients were directly transferred to the angio-suite, one of whom had an intracranial hemorrhage. Fifteen underwent endovascular treatment, representing approximately 50% of endovascular treatments performed within 4.5 hours and 34% of all endovascular treatments performed during the study period. More than half of direct transfer patients had previous neuro-imaging at a primary stroke center, and 44% were primary admissions with no previous neuro-imaging.
Baseline characteristics, including age (71 vs. 72 years; P = .71) and admission NIH Stroke Scale score (18.5 vs. 18; P = .68), did not differ significantly between the direct transfer and standard of care groups.
“In a subgroup of acute stroke patients presenting in the early window, direct transfer and triage in the angio-suite seems feasible, safe and achieves a significant reduction in hospital workflow times,” the researchers wrote. – by Melissa Foster
Reference:
Ribo M. Poster WMP3. Presented at: International Stroke Conference; Feb. 22-24, 2017; Houston.
Disclosure: The researchers report no relevant financial disclosures.