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WORKFLOWS AND TIMELINES OF MECHANICAL THROMBECTOMY FOR ACUTE ISCHAEMIC STROKE IN A HIGH VOLUME STROKE CENTRE: COMPARISON OF REAL-LIFE DATA TO TRIAL AND GUIDELINES TARGETS

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ESOC-2019

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Abstract

Background and Aims: Randomised trials have indicated that mechanical thrombectomy (MT) is a future-guiding treatment modality up to 24 hours after onset of acute ischemic stroke. However to achieve good clinical outcomes, management needs to be well co-ordinated. This study aims to audit workflows and timelines involved with endovascular treatment at the Klinikum Kassel (KK), a German high volume stroke centre, in order to analyse whether standards are in accordance with guidelines and in-house targets. Methods: In this on-going study, patients receiving MT between April 2018 and March 2019 will be evaluated. We analysed the MT scheme timelines, comparing real treatment times with the findings of the HERMES trials and guidelines. Parameters indicative of time-efficiency were the door-to-needle, door-to-groin, onset-to-groin and onset-to-recanalisation times. Further, management times of Mothership (MS) and Drip&Ship (DS) patients will be compared. Results: A total of 92 patients were enrolled between April 2018 and March 2019 . Door-to-needle (M:31min, IQR:23-44min) and door-to-groin (M:78min; IQR:61-94min) times met the guidelines, however KK standards (30 min and 60 min, respectively) were not met in the majority of patients. Onset-to-groin (M:148min; IQR:140-242min) and onset-to-recanalisation (M:218min; IQR:173-274min) times were found to be more time-efficient than HERMES results. MS management resulted in earlier recanalisation compared to DS (Onset-to-recanalisation: MS:194min; DS:289min). Conclusions: Timelines were in accordance with national and international guidelines and more time-efficient than the findings of the HERMES group, nonetheless we would aim for even shorter times in our stroke centre. Further the MS modality proved to be more effective than the DS concept.

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© Copyright 2020 Morressier GmbH.
All rights reserved.