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Titel:

Interdisciplinary Rendez-Vous Approach in Endovascular Stroke Treatment: A New Concept to Accelerate Mechanical Thrombectomy in Primary Stroke Centers.

Dokumenttyp:
Journal Article
Autor(en):
Krug, Nadja; Braun, Holger; Knez, Andreas; Auerbach, Holger; Bodenberger, Stephen; Eglseder, Bettina; Kirschke, Jan; Boeckh-Behrens, Tobias; Wunderlich, Silke; Henninger, Julia; Boy, Sandra; Renz, Martin; Sepp, Dominik; Zimmer, Claus; Maegerlein, Christian
Abstract:
PURPOSE: Prompt endovascular treatment of patients with stroke due to intracranial Large Vessel Occlusion (LVO) is a major challenge in rural areas because neurointerventionalists are usually not available. As a result, treatment is delayed, and clinical outcomes are worse compared with patients primarily treated in comprehensive stroke centers (CSC). To address this problem, we present a concept in which interdisciplinary, on-site endovascular treatment is performed in a Primary Stroke Center (PSC) by a team of interventional neuroradiologists and cardiologists: the Rendez-Vous approach. METHODS: Thirty-five patients with LVO who underwent interdisciplinary thrombectomy on-site at the PSC as part of the Rendez-Vous concept were compared with 72 patients who were transferred from a PSCs to the CSC for thrombectomy when diagnosed with LVO in terms of temporal sequences and clinical outcomes. RESULTS: Patients treated on-site at the PSC as part of the Rendez-Vous approach were managed as successfully and without an increase in complication rates compared with patients treated secondarily at a CSC (91.7% successful interventions in Rendez-Vous vs. 87.3% in control group, p = 0.57). The time from diagnosis of LVO to groin puncture was reduced by mean 74.3 min with the Rendez-Vous concept (p < 0.01). Regarding the clinical outcome, a functionally independent status was achieved in 45.5% in the Rendez-Vous group and in 22.6% in the control group (p = 0.029). CONCLUSION: Thanks to interdisciplinary teamwork between cardiology and interventional neuroradiology in local PSCs, times to successful reperfusion can be reduced. This has a potentially positive impact on the clinical outcome of stroke patients.
Zeitschriftentitel:
Cardiovasc Intervent Radiol
Jahr:
2024
Band / Volume:
47
Heft / Issue:
1
Seitenangaben Beitrag:
109-114
Volltext / DOI:
doi:10.1007/s00270-023-03610-y
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/37989788
Print-ISSN:
0174-1551
TUM Einrichtung:
Klinik und Poliklinik für Neurologie (Prof. Hemmer); Professur für Neuroradiologie (Prof. Zimmer)
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