The aim of this study is to compare time delay and safety parameters of stroke patients initially admitted to a rural primary stroke center (PSC) who receive endovascular treatment (EVT) by a Flying Intervention Team with patients who receive EVT after secondary transfer to a comprehensive stroke center (CSC).
A novel health care concept was implemented in the telemedical stroke network TEMPiS (Telemedical Project for integrative Stroke Care) to reduce time delays to EVT in stroke patients with large vessel occlusion: After telemedicine-assisted identification of EVT candidates in a PSC, a Flying Intervention Team (neuroradiologist and angiography assistant) is flown from a CSC via helicopter to the PSC to perform EVT in the local angiography suite. Flying Intervention Team service runs from 8 a.m. to 10 p.m. Patients remain at local stroke unit for further treatment. Analysis will include time delay to EVT, recanalization, symptomatic intracerebral hemorrhage, periprocedural complications, in-hospital complications, and mortality.
Study Type
OBSERVATIONAL
Enrollment
477
After telemedicine-assisted decision for endovascular treatment, the Flying Intervention Team is transferred via helicopter to the primary stroke center and performs endovascular treatment in the local angiography suite.
TEMPiS TeleStroke Network, Department of Neurology, Munich Municipal Hospital
Munich, Bavaria, Germany
Time from decision for endovascular treatment to groin puncture
Time from telemedicine-assisted decision for endovascular treatment to initiation of endovascular treatment by groin puncture
Time frame: day 1
Time from symptom onset to recanalization
Time from symptom onset to recanalization of previously occluded target artery by endovascular treatment
Time frame: day 1
Other procedural times of hyperacute care
Other procedural times between symptom onset, admission to PSC, first imaging, decision for endovascular treatment, initiation of endovascular treatment and completion of endovascular treatment
Time frame: day 1
Recanalization
Proportion of patients with antegrade reperfusion of more than half of the previously occluded target artery ischemic territory after endovascular treatment
Time frame: day 1
Symptomatic intracerebral hemorrhage
Proportion of patients with symptomatic intracerebral hemorrhage
Time frame: 7 days
In-hospital death or palliative care
In-hospital death or decision for palliative care
Time frame: 7 days
Periprocedural complications
Proportion of patients with periprocedural, endovascular treatment associated complications
Time frame: day 1
In-hospital complications
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Proportion of patients with other in-hospital complications
Time frame: 7 days