Literature DB >> 32772684

Direct Transfer to Angio-Suite Versus Computed Tomography-Transit in Patients Receiving Mechanical Thrombectomy: A Randomized Trial.

Johannes A R Pfaff1, Silvia Schönenberger2, Christian Herweh1, Christian Ulfert1, Simon Nagel2, Peter A Ringleb2, Martin Bendszus1, Markus A Möhlenbruch1.   

Abstract

BACKGROUND AND
PURPOSE: To quantify workflow metrics in patients receiving stroke imaging (noncontrast-enhanced computed tomography [CT] and CT-angiography) in either a computed-tomography scanner suite (CT-Transit [CTT]) or an angio-suite (direct transfer to angio-suite-[DTAS]-using flat-panel CT) before undergoing mechanical thrombectomy.
METHODS: Prospective, single-center investigator initiated randomized controlled trial in a comprehensive stroke center focusing on time from imaging to groin puncture (primary end point) and time from hospital admission to final angiographic result (secondary end point) in patients receiving mechanical thrombectomy for anterior circulation large vessel occlusion after randomization to the CTT or DTAS pathway.
RESULTS: The trial was stopped early after the enrollment of n=60 patients (CTT: n=34/60 [56.7 %]; DTAS: n=26/60 [43.3%]) of n=110 planned patients because of a preplanned interim analysis. Time from imaging to groin puncture was shorter in DTAS-patients (in minutes, median [interquartile range]: CTT: 26 [23-32]; DTAS: 19 [15-23]; P value: 0.001). Time from hospital admission to stroke imaging was shorter in patients randomized to DTAS (CTT: 12 (7-18); DTAS: 21 (15-25), P value: 0.007). Time from hospital admission to final angiographic reperfusion was comparable between patient groups (CTT: 78 [58-92], DTAS: 80 [66-118]; P value: 0.067).
CONCLUSIONS: This trial showed a reduction in time from imaging to groin-puncture when patients are transferred directly to the angiosuite for advanced stroke-imaging compared with imaging in a CT scanner suite. This time saving was outweighed by a longer admission to imaging time and could not translate into a shorter time to final angiographic reperfusion in this trial.

Entities:  

Keywords:  groin; imaging; puncture; reperfusion; stroke; thrombectomy

Mesh:

Year:  2020        PMID: 32772684     DOI: 10.1161/STROKEAHA.120.029905

Source DB:  PubMed          Journal:  Stroke        ISSN: 0039-2499            Impact factor:   7.914


  3 in total

1.  Rescan Time Delays in Ischemic Stroke Imaging: A Retrospective Observation and Analysis of Causes and Clinical Impact.

Authors:  J M Katz; J J Wang; A T Boltyenkov; G Martinez; J O'Hara; C Feizullayeva; M Gribko; A Pandya; P C Sanelli
Journal:  AJNR Am J Neuroradiol       Date:  2021-08-12       Impact factor: 4.966

2.  Evaluation of direct-to-angiography suite (DTAS) and conventional clinical pathways in stroke care: a simulation study.

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

3.  Direct to angiography suite approaches for the triage of suspected acute stroke patients: a systematic review and meta-analysis.

Authors:  Alex Brehm; Ioannis Tsogkas; Johanna M Ospel; Christian Appenzeller-Herzog; Junya Aoki; Kazumi Kimura; Johannes A R Pfaff; Markus A Möhlenbruch; Manuel Requena; Marc J Ribo; Amrou Sarraj; Alejandro M Spiotta; Peter Sporns; Marios-Nikos Psychogios
Journal:  Ther Adv Neurol Disord       Date:  2022-03-02       Impact factor: 6.570

  3 in total

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