'Stroke Room': Diagnosis and treatment at a single location for rapid intraarterial stroke treatment

Andreas Ragoschke-Schumm; Umut Yilmaz; Panagiotis Kostopoulos; Martin Lesmeister; Matthias Manitz; Silke Walter; Stefan Helwig; Lenka Schwindling; Mathias Fousse; Anton Haass; Dominique Garner; Heiko Körner; Safwan Roumia; Iris Grunwald; Ali Nasreldein; Ramona Halmer; Yang Liu; Thomas Schlechtriemen; Wolfgang Reith; Klaus Fassbender

doi:10.1159/000440850

'Stroke Room': Diagnosis and treatment at a single location for rapid intraarterial stroke treatment

Andreas Ragoschke-Schumm, Umut Yilmaz, Panagiotis Kostopoulos, Martin Lesmeister, Matthias Manitz, Silke Walter, Stefan Helwig, Lenka Schwindling, Mathias Fousse, Anton Haass, Dominique Garner, Heiko Körner, Safwan Roumia, Iris Grunwald, Ali Nasreldein, Ramona Halmer, Yang Liu, Thomas Schlechtriemen, Wolfgang Reith, Klaus Fassbender (Lead / Corresponding author)

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

Abstract

Background: For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment.

Methods: Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room').

Result: After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed.

Conclusion: This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT.

Original language	English
Pages (from-to)	251-257
Number of pages	7
Journal	Cerebrovascular Diseases
Volume	40
Issue number	5-6
DOIs	https://doi.org/10.1159/000440850
Publication status	Published - Nov 2015

Keywords

Acute Disease
Aged
Cerebral Angiography
Clinical Protocols
Combined Modality Therapy
Female
Fibrinolytic Agents/therapeutic use
Hospital Units/organization & administration
Hospitals, University/organization & administration
Humans
Infusions, Intra-Arterial
Male
Middle Aged
Patient Care Team
Prospective Studies
Stroke/diagnostic imaging
Tertiary Care Centers/organization & administration
Thrombectomy
Thrombolytic Therapy
Time-to-Treatment
Tissue Plasminogen Activator/therapeutic use
Tomography, X-Ray Computed

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10.1159/000440850

Cite this

Ragoschke-Schumm, A., Yilmaz, U., Kostopoulos, P., Lesmeister, M., Manitz, M., Walter, S., Helwig, S., Schwindling, L., Fousse, M., Haass, A., Garner, D., Körner, H., Roumia, S., Grunwald, I., Nasreldein, A., Halmer, R., Liu, Y., Schlechtriemen, T., Reith, W., & Fassbender, K. (2015). 'Stroke Room': Diagnosis and treatment at a single location for rapid intraarterial stroke treatment. Cerebrovascular Diseases, 40(5-6), 251-257. https://doi.org/10.1159/000440850

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title = "'Stroke Room': Diagnosis and treatment at a single location for rapid intraarterial stroke treatment",

abstract = "Background: For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment.Methods: Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room').Result: After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed.Conclusion: This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT.",

keywords = "Acute Disease, Aged, Cerebral Angiography, Clinical Protocols, Combined Modality Therapy, Female, Fibrinolytic Agents/therapeutic use, Hospital Units/organization & administration, Hospitals, University/organization & administration, Humans, Infusions, Intra-Arterial, Male, Middle Aged, Patient Care Team, Prospective Studies, Stroke/diagnostic imaging, Tertiary Care Centers/organization & administration, Thrombectomy, Thrombolytic Therapy, Time-to-Treatment, Tissue Plasminogen Activator/therapeutic use, Tomography, X-Ray Computed",

author = "Andreas Ragoschke-Schumm and Umut Yilmaz and Panagiotis Kostopoulos and Martin Lesmeister and Matthias Manitz and Silke Walter and Stefan Helwig and Lenka Schwindling and Mathias Fousse and Anton Haass and Dominique Garner and Heiko K{\"o}rner and Safwan Roumia and Iris Grunwald and Ali Nasreldein and Ramona Halmer and Yang Liu and Thomas Schlechtriemen and Wolfgang Reith and Klaus Fassbender",

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year = "2015",

month = nov,

doi = "10.1159/000440850",

language = "English",

volume = "40",

pages = "251--257",

journal = "Cerebrovascular Diseases",

issn = "1015-9770",

publisher = "S. Karger AG",

number = "5-6",

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Ragoschke-Schumm, A, Yilmaz, U, Kostopoulos, P, Lesmeister, M, Manitz, M, Walter, S, Helwig, S, Schwindling, L, Fousse, M, Haass, A, Garner, D, Körner, H, Roumia, S, Grunwald, I, Nasreldein, A, Halmer, R, Liu, Y, Schlechtriemen, T, Reith, W & Fassbender, K 2015, ''Stroke Room': Diagnosis and treatment at a single location for rapid intraarterial stroke treatment', Cerebrovascular Diseases, vol. 40, no. 5-6, pp. 251-257. https://doi.org/10.1159/000440850

TY - JOUR

T1 - 'Stroke Room'

T2 - Diagnosis and treatment at a single location for rapid intraarterial stroke treatment

AU - Ragoschke-Schumm, Andreas

AU - Yilmaz, Umut

AU - Kostopoulos, Panagiotis

AU - Lesmeister, Martin

AU - Manitz, Matthias

AU - Walter, Silke

AU - Helwig, Stefan

AU - Schwindling, Lenka

AU - Fousse, Mathias

AU - Haass, Anton

AU - Garner, Dominique

AU - Körner, Heiko

AU - Roumia, Safwan

AU - Grunwald, Iris

AU - Nasreldein, Ali

AU - Halmer, Ramona

AU - Liu, Yang

AU - Schlechtriemen, Thomas

AU - Reith, Wolfgang

AU - Fassbender, Klaus

PY - 2015/11

Y1 - 2015/11

N2 - Background: For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment.Methods: Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room').Result: After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed.Conclusion: This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT.

AB - Background: For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment.Methods: Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room').Result: After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed.Conclusion: This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT.

KW - Acute Disease

KW - Aged

KW - Cerebral Angiography

KW - Clinical Protocols

KW - Combined Modality Therapy

KW - Female

KW - Fibrinolytic Agents/therapeutic use

KW - Hospital Units/organization & administration

KW - Hospitals, University/organization & administration

KW - Humans

KW - Infusions, Intra-Arterial

KW - Male

KW - Middle Aged

KW - Patient Care Team

KW - Prospective Studies

KW - Stroke/diagnostic imaging

KW - Tertiary Care Centers/organization & administration

KW - Thrombectomy

KW - Thrombolytic Therapy

KW - Time-to-Treatment

KW - Tissue Plasminogen Activator/therapeutic use

KW - Tomography, X-Ray Computed

U2 - 10.1159/000440850

DO - 10.1159/000440850

M3 - Article

C2 - 26484754

SN - 1015-9770

VL - 40

SP - 251

EP - 257

JO - Cerebrovascular Diseases

JF - Cerebrovascular Diseases

IS - 5-6

ER -

'Stroke Room': Diagnosis and treatment at a single location for rapid intraarterial stroke treatment

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