Acute revascularization treatments for ischemic stroke in the Stroke Units of Triveneto, northeast Italy: time to treatment and functional outcomes

Cappellari, Manuel; Bonetti, Bruno; Forlivesi, Stefano; Sajeva, Giulia; Naccarato, Marcello; Caruso, Paola; Lorenzut, Simone; Merlino, Giovanni; Viaro, Federica; Pieroni, Alessio; Giometto, Bruno; Bignamini, Valeria; Perini, Francesco; Boni, Antonella; Morra, M; Critelli, Adriana; Tamborino, Carmine; Tonello, Simone; Guidoni, Silvia Vittoria; L’Erario, Roberto; Russo, Marco; Turinese, Emanuele; Passadore, P.; Zanet, Luca; Polo, Alberto; Turazzini, M.; Basile, Anna; Atzori, Manfredo; Marini, Bruno; Bruno, Martina; Carella, Simona; Campagnaro, Alessandro; Baldi, Antonio; Corazza, Elisa; Zanette, Giampietro; Idone, D.; Gaudenzi, Anna; Bombardi, Roberto; Cadaldini, Morena; Lanzafame, Salvatore; Ferracci, Franco; Zambito, Sandro; Ruzza, Giampietro; Simonetto, Marco; Menegazzo, Elisabetta; Masato, Maela; Padoan, Roberta; Bozzato, Giulio; Paladin, Francesco; Tonon, Agnese; Bovi, Paolo

doi:10.1007/s11239-020-02142-3

Cited by 4 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have reported that early duration between stroke onset to hospital admission improves clinical outcomes in patients with acute ischemic stroke. [5][6][7][8] In the meanwhile, the onset-to-door time of ≤6 hours is crucial for better clinical outcomes. Thus, educating patients with early LVO ischemic changes about the importance of early hospital arrival should be emphasized.…”

mentioning

confidence: 99%

Letter: Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

Wang¹

2022

Neurosurgery

View full text Add to dashboard Cite

with substantial interest an international multicenter retrospective study by Jabbour et al 1 titled "Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study." The authors described the efficacy and outcomes of acute revascularization of admitted patients across 50 participating stroke centers with large vessel occlusion (LVO) in the setting of COVID-19. To further address this, patients were divided into 2 groups (patients with COVID-19 as an experimental group and non-COVID-19 patients as a control group) according to whether the patient had COVID-19. The authors went on to compare baseline characteristics, comorbidities, variables specific to COVID-19, stroke characteristics, treatment characteristics, and clinical outcomes. Subsequently, the results concluded that COVID-19 is an important independent predictor of poor outcomes and incomplete revascularization in patients with LVO. Patients with COVID-19 are younger and have a higher burden of risk factors, higher morbidity, and/or mortality compared with non-COVID-19 patients. In a previously published systematic review, overall poor outcomes and high mortality in patients with COVID-19 after endovascular thrombectomy (EVT) have been identified, 2 which keeps consistent with results in this study. Certainly, we would like to express our respect for the achievements. Some of the conclusions drawn by the authors are well-justified and make real contributions. Overall, the design of the experiment is innovative and is focused on a topic which is of great interest to many working within the field of COVID-19. The statistical analysis conducted is sound and well-chosen. There may be, however, several major drawbacks as it stands.

show abstract

mentioning

confidence: 99%

Letter: Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

Wang¹

2022

Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Our data confirm a previous our study enrolling 512 consecutive ischemic stroke patients who received IVT and/or MT, from September 17 to December 9, 2018, in 25 SUs in Triveneto, a geographical macro-area in Northeast of Italy. Previous study shows a net reduction of patients transferred from a Spoke to a Hub to receive MT, compared with those patients who are directly admitted to a Hub [ 4 ]. In line with the previous observations on “drip-and-ship” model [ 5 ], our study has also reported how onset-to-door time was shorter in the Spokes, while door-to-needle time and needle-to-groin puncture time were shorter in the Hubs.…”

Section: Discussionmentioning

confidence: 99%

Current territorial organization for access to revascularization therapies for acute ischemic stroke in the Veneto region (Italy) from 2017 to 2021

et al. 2023

Self Cite

View full text Add to dashboard Cite

Introduction To evaluate the access to treatments with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) in acute ischemic stroke patients admitted to stroke units (SUs) of Veneto region (Italy) according to current “hub-and-spoke” model from 2017 to 2021. Patients and methods We retrospectively analyzed data on treatments with IVT and/or MT for stroke patients admitted to the 23 SUs (6 Hubs and 17 Spokes) of the 6 macro-areas including 9 local sanitary units (LSUs) and 2 hospitals. Results We reported 6093 treatments with IVT alone, 1114 with IVT plus MT, and 921 with MT alone. Number of stroke unit (SU) beds/100,000 inhabitants ranges from 2.3 to 2.8, and no difference was found among different macro-areas. Number of treatments/100,000 inhabitants/year ranges from 19 to 34 for IVT alone, from 2 to 7 for IVT plus MT, and from 2 to 5 for MT alone. Number of IVT alone/SU bed/year ranges from 9 to 21 in the Hub and from 6 to 12 in the Spokes. Rate of IVT plus MT in patients directly arrived in the same LSU’s Hub ranges from 50 to 81%, likewise the one of MT alone ranges from 49 to 84%. Conclusions Treatment target rates of IVT and MT set by Action Plan for Stroke in Europe 2018–2030 has been globally exceeded in the Veneto region. However, the target rate of MT and access revascularization treatments is heterogeneous among different macro-areas. Further efforts should be made to homogenize the current territorial organization. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-023-06662-7.

show abstract

“…Second, data collection for our study took place in the Netherlands, which is a densely populated country in which hospitals are located relatively close to one another, and there is overall good infrastructure [31]. Furthermore, in our study, the median PSC DTGT was short (144 min) compared to existing literature, in which median PSC DTGTs ranging from 153 to 191 min have been reported [3,[32][33][34].…”

Section: Discussionmentioning

confidence: 84%

Relationship between primary stroke center volume and time to endovascular thrombectomy in acute ischemic stroke

Meenen

Hartog

Groot

et al. 2021

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose:We investigated whether the annual volume of patients with acute ischemic stroke referred from a primary stroke center (PSC) for endovascular treatment (EVT) is associated with treatment times and functional outcome. Methods:We used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) registry (2014)(2015)(2016)(2017). We included patients with acute ischemic stroke of the anterior circulation who were transferred from a PSC to a comprehensive stroke center (CSC) for EVT. We examined the association between EVT referral volume of PSCs and treatment times and functional outcome using multivariable regression modeling. The main outcomes were time from arrival at the PSC to groin puncture (PSC-door-to-groin time), adjusted for estimated ambulance travel times, time from arrival at the CSC to groin puncture (CSC-doorto-groin time), and modified Rankin Scale (mRS) score at 90 days after stroke. Results: Of the 3637 patients in the registry, 1541 patients (42%) from 65 PSCs were included. Mean age was 71 years (SD ± 13.3), median National Institutes of Health Stroke Scale score was 16 (interquartile range [IQR]: 12-19), and median time from stroke onset to arrival at the PSC was 53 min (IQR: 38-90). Eighty-three percent had received intravenous

show abstract

Acute revascularization treatments for ischemic stroke in the Stroke Units of Triveneto, northeast Italy: time to treatment and functional outcomes

Cited by 4 publications

References 15 publications

Letter: Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

Letter: Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

Current territorial organization for access to revascularization therapies for acute ischemic stroke in the Veneto region (Italy) from 2017 to 2021

Relationship between primary stroke center volume and time to endovascular thrombectomy in acute ischemic stroke

Contact Info

Product

Resources

About