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. 2016 Mar;9(2):79-84.
doi: 10.1177/1756285615617081. Epub 2015 Nov 26.

Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy

Ralph Weber  1 , Gernot Reimann  2 , Christian Weimar  3 , Angela Winkler  3 , Klaus Berger  4 , Hannes Nordmeyer  5 , Jeffrie Hadisurya  6 , Friedhelm Brassel  7 , Martin Kitzrow  8 , Christos Krogias  9 , Werner Weber  10 , Elmar W Busch  11 , Jens Eyding  12 ; Neurovascular Net Ruhr
Affiliations

Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy

Ralph Weber et al. Ther Adv Neurol Disord. 2016 Mar.

Erratum in

Abstract

Background: After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated.

Aims: We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit.

Methods: Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network. Data on functional outcome at 3 months was available in 430 (76.4%) patients.

Results: In-hospital mortality (14.8% versus 11.7%, p = 0.26) and 3 months mortality (21.9% versus 24.1%, p = 0.53) were not statistically different in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients, which was mainly caused by a longer interfacility transfer time. We found a nonsignificant trend for better functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0-2, 44.0% versus 35.7%, p = 0.08).

Conclusions: Our results show that a drip-and-ship thrombectomy concept can be effectively organized in a metropolitan stroke network. Every effort should be made to speed up the emergency interfacility transfer to a neurointerventional centre in stroke patients eligible for thrombectomy after initial brain imaging.

Keywords: functional outcome; ischemic stroke; mortality; periprocedural times; referral status; thrombectomy.

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Conflict of interest statement

Conflict of interest statement: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: R.W. received speaker honoria from Covidien and from serving on a scientific advisory board of Covidien. C.W. and H.N. received speaker honoria from Covidien. W.W. received speaker honoria from Penumbra. The other authors declare no conflicts of interest in preparing this article.

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