Raffaele Ornello, MD
Mendez B, Requena M, Aires A, Martins N, Boned S, Rubiera M, et al. Direct Transfer to Angio-Suite to Reduce Workflow Times and Increase Favorable Clinical Outcome: A Case-Control Study. Stroke. 2018
Direct transfer to angio-suite (DTAS) of patients with suspected large vessel occlusion (LVO) ischemic stroke selected before hospital admission may reduce the times and improve the outcomes of endovascular treatment (EVT).
The authors of the present single-center case-control study compared the EVT times and outcomes of 76 patients with LVO and DTAS with those of 145 matched control patients with LVO and no DTAS. Compared with the non-DTAS group, the DTAS group had a 38 minutes shorter time from symptom to recanalization, a 13% increased probability of favorable outcome (modified Rankin Scale score of 0–2) at 90 days, and similar rates of clinical worsening and symptomatic intracranial hemorrhage after EVT.
The study results can only be applied to large comprehensive stroke centers, as the study center has a great experience with pre-hospital selection of LVO patients, stroke care pathways, and EVT. However, the favorable results of the present study may open the way for randomized clinical trials confirming the feasibility, safety, and efficacy of pre-hospital selection and DATS of patients with LVO eligible to EVT.