Aims and objectives
Between December 2014 and August 2016,
6 randomised,
controlled trials and an individual patient data meta-analysis have recently shown that thrombectomy combined with standard treatment is more efficient than standard treatment alone for severe acute stroke caused by large- vessel occlusion in the anterior circulation.
{1-6} International guidelines were recently updated to include recommendation of this treatment.
{7} According to this,
thrombectomy should be available to patients in 24/7 basis.
The aim of this study was to determine (in a high-volume Stroke Center) the distribution...
Methods and materials
Between January 2015 and December 2015 we treated 177 patients with stroke with mechanical thrombectomy,
83% of those in consensus sedation.
We divided the days in the following groups: “weekend and holidays”,
“regular working hours” between 8 am und 4:30 pm in the working week between Monday to Friday,
“rest of the day “between 4:30pm and 10pm in the working week and “late at night” between 10pm and 8am both in the working week and on holidays and at weekends.
We evaluated the distribution of...
Results
Distribution during the time of the day:30% of the cases were during the regular working hours of the working week (Monday to Friday from 8am to 4:30pm),
20% occurred during the working week from 4:30pm until 10pm,
16% late at night during the working week from 10pm until 8am,
34% on holidays and weekend (26% until 10pm and 8% from 10pm until 8am).
( Fig.
1)
Distribution by month of the year: The number of mechanical thrombectomies varied from a minimum of 7 endovascular procedures...
Conclusion
Only 30% of the mechanical thrombectomies were performed during the working hours.
About 24% of the procedures were performed in the night between 10pm-8am and 34% on holidays and at weekends.
The results may have implications for the provision of acute stroke services in Stroke units.
Under optimal conditions interventionalists interventionalists should be available in 24-hour basis,
7 days/week ,365 days/year.
Personal information
Maria Polti,
M.D.,
Ph.D.,
Consultant,
Department of Diagnostic and Interventional Neuroradiology,
Hospital Bremen-mitte,
Germany
e-mail:
[email protected]
Maria Alexandrou,M.D.,
Ph.D.,
Consultant,
Department of Diagnostic and Interventional Neuroradiology,
Hospital Bremen-mitte,
Germany
Blanka Gemes,
M.D.,
Resident,
Department of Diagnostic and Interventional Neuroradiology,
Hospital Bremen-mitte,
Germany
Christian Roth,M.D.,
Ph.
D.,
Associate Professor,
senior consultant,Department of Diagnostic and Interventional Neuroradiology,
Hospital Bremen-mitte,
Germany
Panagiotis Papanagiotou,
M.D.,
Ph.
D.,
Associate Professor,
Director,Department of Diagnostic and Interventional Neuroradiology,
Hospital Bremen-mitte,
Germany
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