Improvement of Endovascular Stroke Treatment: A 24-Hour Neuroradiological On-Site Service Is Not Enough

• Main Authors: Omid Nikoubashman, Kolja Schürmann, Ahmed E. Othman, Jan-Philipp Bach, Martin Wiesmann, Arno Reich
• Format: Article
• Language: English
• Published: Hindawi Limited 2018-01-01
• Series: BioMed Research International
• Online Access: http://dx.doi.org/10.1155/2018/9548743

Background and Purpose. With the advent of endovascular stroke treatment (EST) with mechanical thrombectomy, stroke treatment has also become more challenging. Purpose of this study was to investigate whether a fulltime neuroradiological on-site service and workflow optimization with a structured documentation of the interdisciplinary stroke workflow resulted in improved procedural times. Material and Methods. Procedural times of 322 consecutive patients, who received EST (1) before (n=96) and (2) after (n=126) establishing a 24-hour neuroradiological on-site service as well as (3) after implementation of a structured interdisciplinary workflow documentation (“Stroke Check”) (n=100), were analysed. Results. A fulltime neuroradiological on-site service resulted in a nonsignificant improvement of procedural times during out-of-hours admissions (p≥0.204). Working hours and out-of-hours procedural times improved significantly, if additional workflow optimization was realized (p≤0.026). Conclusions. A 24-hour interventional on-site service is a major prerequisite to adequately provide modern reperfusion therapies in patients with acute ischemic stroke. However, simple measures like standardized and focused documentation that affect the entire interdisciplinary pre- and intrahospital stroke rescue chain seem to be important.