Direct Transfer to Angio-Suite Versus Computed Tomography-Transit in Patients Receiving Mechanical Thrombectomy: A Randomized Trial.
Stroke
; 51(9): 2630-2638, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-32772684
ABSTRACT
BACKGROUND AND PURPOSE:
To quantify workflow metrics in patients receiving stroke imaging (noncontrast-enhanced computed tomography [CT] and CT-angiography) in either a computed-tomography scanner suite (CT-Transit [CTT]) or an angio-suite (direct transfer to angio-suite-[DTAS]-using flat-panel CT) before undergoing mechanical thrombectomy.METHODS:
Prospective, single-center investigator initiated randomized controlled trial in a comprehensive stroke center focusing on time from imaging to groin puncture (primary end point) and time from hospital admission to final angiographic result (secondary end point) in patients receiving mechanical thrombectomy for anterior circulation large vessel occlusion after randomization to the CTT or DTAS pathway.RESULTS:
The trial was stopped early after the enrollment of n=60 patients (CTT n=34/60 [56.7 %]; DTAS n=26/60 [43.3%]) of n=110 planned patients because of a preplanned interim analysis. Time from imaging to groin puncture was shorter in DTAS-patients (in minutes, median [interquartile range] CTT 26 [23-32]; DTAS 19 [15-23]; P value 0.001). Time from hospital admission to stroke imaging was shorter in patients randomized to DTAS (CTT 12 (7-18); DTAS 21 (15-25), P value 0.007). Time from hospital admission to final angiographic reperfusion was comparable between patient groups (CTT 78 [58-92], DTAS 80 [66-118]; P value 0.067).CONCLUSIONS:
This trial showed a reduction in time from imaging to groin-puncture when patients are transferred directly to the angiosuite for advanced stroke-imaging compared with imaging in a CT scanner suite. This time saving was outweighed by a longer admission to imaging time and could not translate into a shorter time to final angiographic reperfusion in this trial.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Trombectomia
/
Acidente Vascular Cerebral
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Stroke
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Alemanha