Raffaele Ornello, MD
Janssen PM, Venema E, Dippel DWJ. Effect of workflow improvements in endovascular stroke treatment: A systematic review and meta-analysis. Stroke. 2019;50:665–674.
Acting fast is of key importance to ensure the success of endovascular treatment (EVT) for ischemic stroke. While the available evidence already showed that workflow interventions improve the time to treatment with intravenous rtPA, the effect of workflow interventions on EVT is less clear. In their systematic review and meta-analysis, the authors included 51 studies referring to workflow interventions in EVT, including anesthetic management, pre-hospital management, in-hospital transfer management, teamwork, and feedback. Overall, each single intervention resulted in a significant improvement of time to EVT, with a mean value of 26 minutes and up to 64 minutes for feedback interventions.
Although limited by the large contribution of retrospective data and by the low availability of pre-hospital management data, the published systematic review and meta-analysis underlines the importance and effectiveness of planning adequate EVT workflow intervention in clinical practice to improve the treatment time of ischemic stroke and patient outcomes.