Nation-wide survey of use of intravenous rt-PA (alteplase) therapy during the first four years after approval -For overcoming regional gaps-

靖, 岡田; 一夫, 峰松; 彰, 小川; 雄一, 今中; 美穂, 関本; 和夫, 端; 武典, 山口

doi:10.3995/jstroke.32.365

Cited by 17 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several randomized controlled trials (RCTs) and meta-analysis have reported the effectiveness of these treatments [6][7][8]. Despite the efficacy, disparity in implementation rates of the treatments between rural areas and urban areas have been reported due to their time limits [9,10]. Furthermore, the later the reperfusion is performed, the worse the outcome will be [11].…”

Section: Introductionmentioning

confidence: 99%

Cost Effectiveness of Drive and Retrieve System in Hokkaido for Acute Ischemic Stroke Patient Treatment Using Geographic Information System

Morii

Osanai

Ishikawa

et al. 2019

Journal of Stroke and Cerebrovascular Diseases

View full text Add to dashboard Cite

Background and Purpose: Although endovascular thrombectomy combined with recombinant tissue-type plasminogen activator is effective for treatment of acute ischemic stroke, regional disparities in implementation rates of those treatments have been reported. Drive and retrieve system, where a qualified neurointerventionist travels to another primary stroke center for endovascular thrombectomy, has been practiced in parts of Hokkaido, Japan. This study aims to simulate he cost-effectiveness of the drive and retrieve system, which can be a method to enhance equality and cost-effective of treatments for acute ischemic stroke. Materials and methods: The number of patients who had acute ischemic stroke in 2015 is estimated. Those patients are generated according to the population distribution, and thereafter patient transport time is analyzed in the three scenarios (1) 60-minute drive scenario, (2) 90-minute drive scenario, in which the drive and retrieve system operates within 60-minute or 90-minute driving distance (3) without the system, using geographic information system. Incremental cost-effectiveness rate, quality adjusted life years, and medical and nursing care costs are estimated from the analyzed transport time.

show abstract

Section: Introductionmentioning

confidence: 99%

Cost Effectiveness of Drive and Retrieve System in Hokkaido for Acute Ischemic Stroke Patient Treatment Using Geographic Information System

Morii

Osanai

Ishikawa

et al. 2019

Journal of Stroke and Cerebrovascular Diseases

View full text Add to dashboard Cite

show abstract

“…A national survey conducted in 2010 showed that lesser than 5% of eligible Japanese patients had received rt-PA therapy and that by 2009, 44 of 348 emergency medical service areas (12.6%) did not deliver the iv rt-PA treatment. 7) …”

Section: Introductionmentioning

confidence: 99%

Drip-and-Ship Thrombolytic Therapy Supported by the Telestroke System for Acute Ischemic Stroke Patients Living in Medically Under-served Areas

Kageji

Obata

Oka

et al. 2016

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

There are a few stroke specialists in medically under-served areas in Japan. Consequently, in remote area patients may not receive thrombolysis with intravenous recombinant tissue plasminogen activator (iv rt-PA), the standard treatment for acute ischemic stroke. Using a mobile telestroke support system (TSS) that accesses the internet via a smart phone, we implemented iv rt-PA infusion therapy under a drip-and-ship protocol to treat the stroke patients in medically under-served areas. The physicians at the Tokushima Prefectural Kaifu Hospital (TPKH), located in rural Japan, can relay CT or MRI scans and other patient data via their smart phone to off-site stroke specialists. In the course of 34 months, we used the TSS in 321 emergencies. A total of 9 of 188 (4.8%) with acute ischemic stroke, received iv rt-PA infusion therapy using a mobile TSS; in 5 among these (55.6%), we obtained partial or complete recanalization of occluded arteries. None suffered post-treatment hemorrhage and their average NIH stroke score fell from 14.6 at the time of admission to 6.8 at 24 h post-infusion. The drip-and-ship protocol contributed to the safe and effective treatment of the stroke patients living in medically under-served rural areas.

show abstract

Guidelines for the Intravenous Application of Recombinant Tissue-type Plasminogen Activator (Alteplase), the Second Edition, October 2012: A Guideline From the Japan Stroke Society

Minematsu

Toyoda

Hirano

et al. 2013

Journal of Stroke and Cerebrovascular Diseases

127

103

View full text Add to dashboard Cite

Nation-wide survey of use of intravenous rt-PA (alteplase) therapy during the first four years after approval -For overcoming regional gaps-

Cited by 17 publications

References 10 publications

Cost Effectiveness of Drive and Retrieve System in Hokkaido for Acute Ischemic Stroke Patient Treatment Using Geographic Information System

Cost Effectiveness of Drive and Retrieve System in Hokkaido for Acute Ischemic Stroke Patient Treatment Using Geographic Information System

Drip-and-Ship Thrombolytic Therapy Supported by the Telestroke System for Acute Ischemic Stroke Patients Living in Medically Under-served Areas

Guidelines for the Intravenous Application of Recombinant Tissue-type Plasminogen Activator (Alteplase), the Second Edition, October 2012: A Guideline From the Japan Stroke Society

Contact Info

Product

Resources

About