Abstract
Objective
It is not clear how patients with large vessel occlusion (LVO) who have undergone
mechanical thrombectomy (MT) were transported to hospitals by emergency medical services.
Here, we describe the current status of the stroke delivery system in a large city.
Methods
We investigated data from 328 patients (male, n = 199; average age, 74.8 ± 12.9 years)
who underwent MT at 12 facilities in the Tama area of Tokyo, between January 2015
and December 2017. The patients were classified according to the destination institution
as Stroke A eligible (group A, n = 266 [8.2%]), Tertiary critical care center (group
T; n = 35 [10.7%]), and other destinations such as emergency rooms (group O; n = 27
[8.2%]), and then reasons for using Emergency Medical Service (EMS) services and outcomes
were compared among the groups.
Results
Rates of milder stroke, and middle cerebral artery occlusion were significantly higher
in group A than T, whereas that of vertebral-basilar artery occlusion was significantly
lower in group A than in groups T and O. The amount of elapsed time from door to picture
(DTP) was significantly lower in group A. The time from onset to recanalization, as
well as rates of successful recanalization and favorable outcomes (90-day modified
Rankin scale 0-2) did not significantly differ regardless of destination.
Conclusions
Most patients with LVO in the Tama area were categorized into group A. DTP was significantly
lower in group A.
Key Words
Abbreviations:
CPSS (Cincinnati Prehospital Stroke Scale Score), DTP (Door to picture), DTR (Door to recanalization), LVO (Large vessel occlusion), MT (Mechanical thrombectomy), mTICI (Modified thrombolysis in cerebral infarction), OTD (Onset to door), OTR (Onset to recanalization), pc-ASPECTS (Posterior circulation Alberta Stroke Program Early CT Score), PTP (Picture to puncture), PTR (Puncture to recanalization), t-PA (Tissue plasminogen activator, Tama Registry of Acute Thrombectomy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 07, 2020
Accepted:
February 10,
2020
Received:
December 19,
2019
Footnotes
Funding: This registry is partially supported by Taiju Life Social Welfare Foundation (Grant number: 00000253). The funders had no role in the execution of this study or the interpretation of the results.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104752
Copyright
© 2020 Elsevier Inc. All rights reserved.
