Comparison of a novel inter-hospital system “Mobile Endovascular Therapy Team” and patient transfer system in mechanical thrombectomy for acute ischemic stroke

Abstract

Objective:In mechanical thrombectomy for acute ischemic stroke, we formed a neurointerventional team called "Mobile Endovascular Therapy Team (MET)" to offer EVT at outside hospitals. In this study, we compared the elapsed time until the beginning of EVT between patients who performed EVT at outside hospitals and who received EVT in our hospital after they were transferred. Method: From July 2012 to June 2015, acute ischemic stroke patients who performed EVT within 8 hours from onset by MET (MET group) and received EVT after they were transferred to our hospital (transfer group) were enrolled. We defined the beginning of EVT as the time of injection from guiding catheter for EVT. We compared the time from initial imaging to the beginning of EVT ("picture to treatment" time) between the two groups. Results; Fifty-five patients in MET group and 9 patients in transfer group were analyzed. Picture to groin puncture time (MET group vs. transfer group: 54 minutes vs. 128 minutes, p < 0.0001), picture to treatment time (105 minutes vs. 168 minutes, p = 0.0003), and notification to treatment time (80 minutes vs. 125 minutes, p<0.0001) were significantly shorter in MET group than in transfer group. Conclusions: MET can provide EVT at outside hospitals without time delay and can be an alternative system to patient transfer.•

Outcomes and Issues of ‘Drip and Go’ as an Inter-Hospital Cooperation System in Mechanical Thrombectomy for Acute Ischemic Stroke

“…Several studies that compared trip treatment by a mobile stroke team, termed “Trip and Treat” or “Drip and Drive” systems, with direct transportation, 19 – 21) which are similar to our own reported that physician trip thrombectomy group had significantly shorter imaging to puncture time than patient transfer group within 50- to 60-km areas and urban areas. The furthest hospital included in the current study was also located approximately 60-km away, requiring approximately 1 hour for transfer by car.…”