Higher volume endovascular stroke centers have faster times to treatment, higher reperfusion rates and higher rates of good clinical outcomes

Journal of Neurointerventional Surgery
Rishi GuptaRaul G Nogueira

Abstract

Technological advances have helped to improve the efficiency of treating patients with large vessel occlusion in acute ischemic stroke. Unfortunately, the sequence of events prior to reperfusion may lead to significant treatment delays. This study sought to determine if high-volume (HV) centers were efficient at delivery of endovascular treatment approaches. A retrospective review was performed of nine centers to assess a series of time points from obtaining a CT scan to the end of the endovascular procedure. Demographic, radiographic and angiographic variables were assessed by multivariate analysis to determine if HV centers were more efficient at delivery of care. A total of 442 consecutive patients of mean age 66 ± 14 years and median NIH Stroke Scale score of 18 were studied. HV centers were more likely to treat patients after intravenous administration of tissue plasminogen activator and those transferred from outside hospitals. After adjusting for appropriate variables, HV centers had significantly lower times from CT acquisition to groin puncture (OR 0.991, 95% CI 0.989 to 0.997, p=0.001) and total procedure times (OR 0.991, 95% CI 0.986 to 0.996, p=0.001). Additionally, patients treated at HV centers were more likely to...Continue Reading

References

Jun 24, 2000·JAMA : the Journal of the American Medical Association·M J AlbertsM D Walker
Mar 30, 2006·European Heart Journal·Christian SpauldingUNKNOWN CARDIO-ARIF registry Investigators
Feb 3, 2007·Stroke; a Journal of Cerebral Circulation·Joung-Ho Rha, Jeffrey L Saver
Sep 30, 2009·Neurology·P KhatriUNKNOWN IMS I and II Investigators
Oct 9, 2009·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Jefferson T MileyAdnan I Qureshi
Aug 19, 2010·JAMA : the Journal of the American Medical Association·Christian Juhl TerkelsenJens Flensted Lassen
Apr 30, 2011·Stroke; a Journal of Cerebral Circulation·Shyam PrabhakaranThomas P Bleck
May 25, 2011·Journal of Thrombosis and Thrombolysis·Eliano Pio NavareseSilvio Klugmann
Jun 3, 2011·The New England Journal of Medicine·Jonathan F FinksJohn D Birkmeyer
Jun 24, 2011·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·M EesaM Goyal

❮ Previous
Next ❯

Citations

Mar 29, 2014·AJNR. American Journal of Neuroradiology·S PrabhakaranS A Ansari
Sep 26, 2015·International Journal of Stroke : Official Journal of the International Stroke Society·J MoccoJeffery L Saver
Jul 15, 2015·Annals of Neurology·Sunil A ShethUNKNOWN SWIFT-STAR Trialists
Mar 30, 2016·Current Neurology and Neuroscience Reports·Jessalyn K HolodinskyMichael D Hill
Jul 19, 2014·European Journal of Internal Medicine·Jonathan BirnsAjay Bhalla
Sep 1, 2015·Journal of Vascular and Interventional Radiology : JVIR·David Sacks
Mar 15, 2015·Journal of Neurointerventional Surgery·Kyle M FargenJ Mocco
Jun 4, 2016·Journal of the American College of Cardiology·Maxim MokinL Nelson Hopkins
Sep 14, 2016·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Charlotte ZernaMichael D Hill
Jan 20, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Evgenia KlourfeldUNKNOWN ESCAPE Trial Investigators
Apr 14, 2016·Journal of Neurointerventional Surgery·Shyam PrabhakaranOsama O Zaidat
Jun 26, 2017·Practical Neurology·Matthew R B EvansDavid J Werring
Jan 20, 2018·Journal of Neurointerventional Surgery·William J MackFelipe C Albuquerque
Mar 29, 2014·Nature·Catherine N HallDavid Attwell
Jan 30, 2015·Journal of Clinical Neurology·Ramana M R AppireddyMichael D Hill
Dec 15, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Takahiro OtaNobuhito Saito
Aug 30, 2014·Stroke; a Journal of Cerebral Circulation·Mayank GoyalJeffrey Saver
Feb 6, 2017·Circulation Research·Luciana CataneseMarc Fisher
Sep 17, 2017·Stroke; a Journal of Cerebral Circulation·Nicholas C BambakidisUNKNOWN American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Cerebrovascular Section (Endorsed by S
Aug 8, 2013·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatUNKNOWN STIR Thrombolysis in Cerebral Infarction (TICI) Task Force
May 2, 2015·Stroke; a Journal of Cerebral Circulation·Kyle M FargenJ Mocco
Feb 7, 2015·Stroke; a Journal of Cerebral Circulation·Jay Chol ChoiAnthony S Kim
Feb 15, 2015·Stroke; a Journal of Cerebral Circulation·Bijoy K MenonEric E Smith
Mar 13, 2014·Circulation·Chung-Huan J SunRishi Gupta
Mar 25, 2017·Stroke; a Journal of Cerebral Circulation·Lorenzo RinaldoAlejandro A Rabinstein
Feb 7, 2019·Stroke; a Journal of Cerebral Circulation·Hamidreza SaberSunil A Sheth
Jan 22, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Joseph B MillerJon W Schrock
Mar 14, 2019·Stroke; a Journal of Cerebral Circulation·Esmee VenemaBob Roozenbeek
Apr 5, 2019·Stroke; a Journal of Cerebral Circulation·Byung Moon KimYoung Dae Kim
Jul 19, 2019·Stroke; a Journal of Cerebral Circulation·Raul G NogueiraOsama O Zaidat
Nov 19, 2019·Stroke; a Journal of Cerebral Circulation·Marielle ErnstCaspar Brekenfeld
Sep 28, 2018·BMJ Quality & Safety·Stephanie MuellerJeffrey L Schnipper
Feb 23, 2020·Stroke; a Journal of Cerebral Circulation·Henry ZhaoStephen M Davis
Dec 3, 2015·Journal of Neurointerventional Surgery·Gabriel Vidal, James Milburn

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of the American College of Surgeons
Leo M GazoniIvan K Crosby
Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
David TraulLena Varner
Journal of Surgical Oncology
Amanda V HaymanDavid J Bentrem
HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Anand SinglaShimul A Shah
© 2021 Meta ULC. All rights reserved