Marios-Nikos Psychogios1, Daniel Behme2, Katharina Schregel2, Ioannis Tsogkas2, Ilko L Maier2, Johanna Rosemarie Leyhe2, Antonia Zapf2, Julia Tran2, Mathias Bähr2, Jan Liman2, Michael Knauth2. 1. From the Department of Neuroradiology (M.N.P., D.B., K.S., I.T., J.R.L., J.T., M.K.), Neurology (I.L.M., M.B., J.L.), and Medical Statistics (A.Z.), University Medical Center Göttingen, Germany; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (K.S.). m.psychogios@med.uni-goettingen.de. 2. From the Department of Neuroradiology (M.N.P., D.B., K.S., I.T., J.R.L., J.T., M.K.), Neurology (I.L.M., M.B., J.L.), and Medical Statistics (A.Z.), University Medical Center Göttingen, Germany; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (K.S.).
Abstract
BACKGROUND AND PURPOSE: Intrahospital time delays significantly affect the neurological outcome of stroke patients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. METHODS: In this observational study, we report the first 30 consecutive stroke patients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT). Preinterventional imaging consisted of noncontrast flat detector CT and flat detector CT angiography, acquired with an angiography system. Patients with large-vessel occlusions remained on the angio table and were treated with mechanical thrombectomy; patients with small artery occlusions were treated with intravenous thrombolysis, whereas patients with an intracranial hemorrhage and stroke mimics were treated as per guidelines. Door-to-groin puncture times were recorded and compared with our past results. RESULTS: Thirty patients were transferred directly to our angio suite from June to December 2016. The time from symptom onset to admission was 105 minutes. Ischemic stroke was diagnosed in 22 of 30 (73%) patients, 4 of 30 (13.5%) had an intracranial hemorrhage, and 4 of 30 (13.5) were diagnosed with a Todd's paresis. Time from admission to groin puncture was 20.5 minutes. Compared with 44 patients imaged with multidetector CT in the first 6 months of 2016, door-to-groin times were significantly reduced (54.5 minutes [95% confidence interval, 47-61] versus 20.5 minutes [95% confidence interval, 17-26]). CONCLUSIONS: In this small series, a one-stop management protocol of selected stroke patients using latest generation flat detector CT led to a significant reduction of intrahospital times.
BACKGROUND AND PURPOSE: Intrahospital time delays significantly affect the neurological outcome of strokepatients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. METHODS: In this observational study, we report the first 30 consecutive strokepatients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT). Preinterventional imaging consisted of noncontrast flat detector CT and flat detector CT angiography, acquired with an angiography system. Patients with large-vessel occlusions remained on the angio table and were treated with mechanical thrombectomy; patients with small artery occlusions were treated with intravenous thrombolysis, whereas patients with an intracranial hemorrhage and stroke mimics were treated as per guidelines. Door-to-groin puncture times were recorded and compared with our past results. RESULTS: Thirty patients were transferred directly to our angio suite from June to December 2016. The time from symptom onset to admission was 105 minutes. Ischemic stroke was diagnosed in 22 of 30 (73%) patients, 4 of 30 (13.5%) had an intracranial hemorrhage, and 4 of 30 (13.5) were diagnosed with a Todd's paresis. Time from admission to groin puncture was 20.5 minutes. Compared with 44 patients imaged with multidetector CT in the first 6 months of 2016, door-to-groin times were significantly reduced (54.5 minutes [95% confidence interval, 47-61] versus 20.5 minutes [95% confidence interval, 17-26]). CONCLUSIONS: In this small series, a one-stop management protocol of selected strokepatients using latest generation flat detector CT led to a significant reduction of intrahospital times.
Authors: A Brehm; I Tsogkas; I L Maier; H J Eisenberger; P Yang; J-M Liu; J Liman; M-N Psychogios Journal: AJNR Am J Neuroradiol Date: 2019-07-11 Impact factor: 3.825
Authors: Johanna Maria Ospel; Ryan McTaggart; Nima Kashani; Marios Psychogios; Mohammed Almekhlafi; Mayank Goyal Journal: Semin Intervent Radiol Date: 2020-05-14 Impact factor: 1.513
Authors: Volker Maus; Silja Henkel; Alexander Riabikin; Christian Riedel; Daniel Behme; Ioannis Tsogkas; Amelie Carolina Hesse; Nuran Abdullayev; Olav Jansen; Martin Wiesmann; Anastasios Mpotsaris; Marios-Nikos Psychogios Journal: Clin Neuroradiol Date: 2018-07-19 Impact factor: 3.649
Authors: Mehrad Bastani; Timothy G White; Gabriela Martinez; Joseph Ohara; Kinpritma Sangha; Michele Gribko; Jeffrey M Katz; Henry H Woo; Artem T Boltyenkov; Jason Wang; Elizabeth Rula; Jason J Naidich; Pina C Sanelli Journal: J Neurointerv Surg Date: 2021-12-06 Impact factor: 8.572
Authors: Johanna Maria Ospel; Ryan McTaggart; Nima Kashani; Marios Psychogios; Mohammed Almekhlafi; Mayank Goyal Journal: Semin Intervent Radiol Date: 2020-05-14 Impact factor: 1.513
Authors: Wolfram Doehner; Mikael Mazighi; Bernd M Hofmann; Dominik Lautsch; Gerhard Hindricks; Erin A Bohula; Robert A Byrne; A John Camm; Barbara Casadei; Valeria Caso; Christophe Cognard; Hans-Christoph Diener; Matthias Endres; Patrick Goldstein; Alison Halliday; Jemma C Hopewell; Dejana R Jovanovic; Adam Kobayashi; Maciej Kostrubiec; Antonin Krajina; Ulf Landmesser; Hugh S Markus; George Ntaios; Francesca R Pezzella; Marc Ribo; Giuseppe Mc Rosano; Marta Rubiera; Mike Sharma; Rhian M Touyz; Petr Widimsky Journal: Eur J Prev Cardiol Date: 2019-09-30 Impact factor: 7.804
Authors: Marios-Nikos Psychogios; Peter B Sporns; Johanna Ospel; Aristeidis H Katsanos; Reza Kabiri; Fabian A Flottmann; Bijoy K Menon; Mackenzie Horn; David S Liebeskind; Tristan Honda; Marc Ribo; Manuel Requena Ruiz; Christoph Kabbasch; Thorsten Lichtenstein; Christoph J Maurer; Ansgar Berlis; Victoria Hellstern; Hans Henkes; Markus A Möhlenbruch; Fatih Seker; Marielle S Ernst; Jan Liman; Georgios Tsivgoulis; Alex Brehm Journal: Clin Neuroradiol Date: 2020-11-20 Impact factor: 3.649
Authors: Omid Nikoubashman; Kolja Schürmann; Ahmed E Othman; Jan-Philipp Bach; Martin Wiesmann; Arno Reich Journal: Biomed Res Int Date: 2018-01-04 Impact factor: 3.411