[Current Status of Thrombectomy Calls for Acute Ischemic Stroke for a Single Neurointerventionist in a Regional Hospital].

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the current status of thrombectomy calls for acute ischemic stroke for a single neurointerventionist in a regional hospital. METHODS: We retrospectively evaluated patients with thrombectomy calls for a neurointerventionist from January to November 2016 in our hospital, where a single board-certified neurointerventionist conducts endovascular interventions. Number, frequency, and time of thrombectomy calls were analyzed. Patients ineligible for revascularization were still used in analysis even though the neurointerventionist did not perform thrombectomy. RESULTS: Over 11 months(334 days), there were 105 calls, of which 48 were during duty hours and 57 during off-duty hours. The neurointerventionist was called once every 3.2 days in total, once every 4.7 days during duty hours, once every 5.7 days during off-duty hours of working days, and once every 6.2 days during holidays. Thrombectomies were performed in 37 cases(35%). Thrombectomies were performed once every 9.1 days and once every 2.8 calls. Twenty-four patients presented with ischemic stroke with large vessel occlusion, but they were determined to be ineligible for thrombectomy because of progressed ischemia in 7 patients, poor clinical condition in 7, or symptom recovery or recanalization in 10. Diagnoses of 42 patients who were not indicated for thrombectomy included ischemic stroke without major artery occlusion in 24 patients and intracerebral hemorrhage in 14. CONCLUSION: In a regional hospital with a single neurointerventionist, the frequency of thrombectomy calls was about once in every 3 days, and approximately half of them occurred during off-duty hours. A thrombectomy was performed about once every 9 days and about once every 3 thrombectomy-calls. Measures should be taken to reduce the burden on neurointerventionists in stroke centers, especially in understaffed institutes.