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Mobile interventional stroke teams improve treatment times
Treatment times for thrombectomy in large vessel occlusion were improved due to mobile interventional stroke teams in the trip-and-treat model, according to data published in Stroke.
To compare the drip-and-ship model, in which patients are treated with IV tissue-type plasminogen activator (tPA) at the nearest hospital, and the trip-and-treat model, using the concept of a mobile interventional stroke team that travels to stroke centers, Johanna T. Fifi, MD, from the departments of neurology, neurosurgery and radiology at Icahn School of Medicine at Mount Sinai, and colleagues conducted a retrospective analysis consisting of 86 consecutive patients with acute ischemic stroke secondary to large vessel occlusion who received endovascular treatment.
The study took place across four hospitals in New York City and divided patients into trip-and-treat (n = 39) and drip-and-ship cohorts (n = 47).
The primary outcome was initial door-to-puncture time, which the researchers defined as the time between arrival at any hospital and arterial puncture.
The times of last known well, IV tPA administration, transfer and reperfusion were also recorded and analyzed by the researchers.
Initial door-to-puncture time was 79 minutes faster (143 minutes vs. 222 minutes) among patients in the trip-to-treat cohort compared with those in the drip-and-ship group (P < .0001).
Although there was a trend in longer puncture-to-recanalization times for trip-and-treat (P = .0887), initial door-to-recanalization was nonetheless 79 minutes faster for trip-and-treat (P < .00001), the researchers wrote.
Additionally, the researchers found that the trip-and-treat group had a trend in improved admission-to-discharge change in NIH Stroke Scale score compared with the drip-and-ship group (P = .0704).
“This study suggests that [mobile interventional stroke teams] in a trip-and-treat model is an effective model for providing thrombectomy care across a dense urban geographic region,” Fifi and colleagues wrote. “Trip-and-treat model provides a new framework for stroke networks to optimize endovascular treatment. Future studies will be needed to prospectively compare trip-and-treat, drip-and-ship and mothership models with randomization and treatment.”– by Dave Quaile
Disclosures: The authors report no relevant financial disclosures.