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Mobile stroke care expedites intravenous thrombolysis and endovascular thrombectomy

Stroke & Vascular Neurology 2022年第3期7卷 209-214页

作者： matthew t bender.thomas k mattingly Redi Rahmani Diana Proper Walter A Burnett Jason L Burgett Joshua LEsperance Jeremy t Cushman Webster H Pilcher Curtis G Benesch Adam G kelly tarun Bhalla Department of Neurosurgery University of Rochester Medical CenterRochesterNew YorkUSA Department of Emergency Medicine University of Rochester Medical CenterRochesterNew YorkUSA Department of Neurology University of Rochester Medical CenterRochesterNew YorkUSA

Background the number of mobile stroke programmes has increased with evidence,showing they expedite intravenous *** questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical *** Our mobile stroke unit(MSU),based at an academic medical centre in upstate New York,launched in October *** reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service(EMS)patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical *** Over 568 days in service,the MSU was dispatched 1489 times(2.6/day)and transported 300 patients(20%of dispatches).Intravenous tissue plasminogen activator(tPA)was administered to 57 MSU patients and the average time from 911 call-to tPA was 42.5 min(±9.2),while EMS transported 73 patients who received tPA at 99.4 min(±35.7)(ptients(12%)received tPA from 3.5 hours to 4.5 hours since last known well and would likely have been outside the window with EMS *** thrombectomy was performed on 21 MSU patients with an average 911 call-to groin puncture time of 99.9 min(±18.1),while EMS transported 54 patients who underwent endovascular thrombectomy(Et)at 133.0 min(±37.0)(p=0.0002).there was no difference between MSU and traditional EMS in modified Rankin score at 90-day clinic follow-up for patients undergoing intravenous thrombolysis or endovascular thrombectomy,whether assessed as a dichotomous or ordinal *** Mobile stroke care expedited both intravenous thrombolysis and endovascular *** is an ongoing need to show improved functional outcomes with MSU care.

关键词： intravenous throm endovascular

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