Mobile Stroke Unit Computed Tomography Angiography Substantially Shortens Door-to-Puncture Time.

Abstract:

:Background and Purpose- Endovascular thrombectomy (ET) door-to-puncture time (DTPT) is a modifiable metric. One of the most important, yet time-consuming steps, is documentation of large vessel occlusion by computed tomography angiography (CTA). We hypothesized that obtaining CTA on board a Mobile Stroke Unit and direct alert of the ET team shortens DTPT by over 30 minutes. Methods- We compared DTPT between patients having CTA onboard the Mobile Stroke Unit then subsequent ET from September 2018 to November 2019 and patients in Mobile Stroke Unit from August 2014 to August 2018, when onboard CTA was not yet being used. We also correlated DTPT with change in National Institutes of Health Stroke Scale between baseline and 24 hours. Results- Median DTPT was 53.5 (95% CI, 35-67) minutes shorter with onboard CTA and direct ET team notification: 41 minutes (interquartile range, 30.0-63.5) versus 94.5 minutes (interquartile range, 69.8-117.3; P<0.001). Median on-scene time was 31.5 minutes (interquartile range, 28.8-35.5) versus 27.0 minutes (interquartile range, 23.0-31.0) (P<0.001). Shorter DTPT correlated with greater improvement of National Institutes of Health Stroke Scale (correlation=-0.2, P=0.07). Conclusions- Prehospital Mobile Stroke Unit management including on-board CTA and ET team alert substantially shortens DTPT. Registration- URL: https://clinicaltrials.gov; Unique identifier: NCT02190500.

journal_name

Stroke

journal_title

Stroke

authors

Czap AL,Singh N,Bowry R,Jagolino-Cole A,Parker SA,Phan K,Wang M,Sheth SA,Rajan SS,Yamal JM,Grotta JC

doi

10.1161/STROKEAHA.119.028626

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1613-1615

issue

5

eissn

0039-2499

issn

1524-4628

journal_volume

51

pub_type

杂志文章

相关文献

STROKE文献大全
  • Delayed cerebral ischemia following arteriography.

    abstract::Cerebral ischemic events associated with arteriography are usually attributed to catheter-induced emboli. We present three patients with cerebral ischemia occurring 6 to 48 hours post-arteriography. We suspected that alternate pathogenic mechanisms were in effect. To evaluate the possibility that sustained platelet ac...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.16.3.431

    authors: Fisher M,Sandler R,Weiner JM

    更新日期:1985-05-01 00:00:00

  • Selective brain cooling during and after prolonged global ischemia reduces cortical damage in rats.

    abstract:BACKGROUND AND PURPOSE:Studies of the cerebroprotective effects of selective brain cooling have failed to show amelioration of ischemic injury in the cerebral cortex. This study was designed to test the hypothesis that mild-to-moderate selective brain cooling initiated after the onset of global brain ischemia in rats p...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.12.1792

    authors: Kuluz JW,Gregory GA,Yu AC,Chang Y

    更新日期:1992-12-01 00:00:00

  • Cerebral pathophysiology in hemorrhagic shock. Nuclide scan data, fluorescence microscopy, and anatomic correlations.

    abstract::Nineteen unanesthetized sheep were given Evans blue dye or radionuclide and then were incrementally bled into hemorrhagic shock (BP less than 50/25) by withdrawal of blood over a period of approximately one hour. Four sheep served as controls for histologic data. Static nuclide brain scans performed in 6 bled sheep d...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.11.1.50

    authors: Bronshvag MM

    更新日期:1980-01-01 00:00:00

  • Intravenous recombinant tissue plasminogen activator in a pregnant woman with cardioembolic stroke.

    abstract:BACKGROUND AND PURPOSE:Historically, the use of tissue plasminogen activator (tPA) thrombolysis in pregnancy has been regarded as relatively contraindicated. Underlying this stance has been the concern over the risk of bleeding complications in both mother and child. SUMMARY OF CASE:We report the successful use of int...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000230286.95513.c2

    authors: Wiese KM,Talkad A,Mathews M,Wang D

    更新日期:2006-08-01 00:00:00

  • Feeding artery pressure and venous drainage pattern are primary determinants of hemorrhage from cerebral arteriovenous malformations.

    abstract:PURPOSE:The purpose of this study was to define the influence of feeding mean arterial pressure (FMAP) in conjunction with other morphological or clinical risk factors in determining the probability of hemorrhagic presentation in patients with cerebral arteriovenous malformations (AVMs). METHODS:Clinical and angiograp...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.29.6.1167

    authors: Duong DH,Young WL,Vang MC,Sciacca RR,Mast H,Koennecke HC,Hartmann A,Joshi S,Mohr JP,Pile-Spellman J

    更新日期:1998-06-01 00:00:00

  • Mechanisms and timing of deaths from cerebral infarction.

    abstract::Clinicopathologic correlations were reviewed in 100 cases of recent cerebral infarctions in the internal carotid artery distribution. The most frequent cause of death was transtentorial herniation, followed in frequency by pneumonia, cardiac causes, and pulmonary embolism. Thirty-six percent of all patients and 47% of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.12.4.474

    authors: Bounds JV,Wiebers DO,Whisnant JP,Okazaki H

    更新日期:1981-07-01 00:00:00

  • Nonsteroidal lazaroid U78517F in models of focal and global ischemia.

    abstract::U78517F is a novel inhibitor of iron-catalyzed lipid peroxidation that combines the tetramethylchroman antioxidant ring portion of alpha-tocopherol with the amine of the previously described 21-aminosteroids (e.g., U74006F). U78517F inhibited 200 microM FeCl2-initiated lipid peroxidation in rat brain homogenates by 50...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:

    authors: Hall ED,Pazara KE,Braughler JM,Linseman KL,Jacobsen EJ

    更新日期:1990-11-01 00:00:00

  • Nitric oxide and the cerebral circulation.

    abstract:BACKGROUND:Nitric oxide (NO) is a potent vasodilator that was initially described as the mediator of endothelium-dependent relaxation (endothelium-derived relaxing factor, EDRF). It is now known that NO is produced by a variety of other cell types. SUMMARY OF REVIEW:Endothelium produces NO (EDRF) under basal condition...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.str.25.3.692

    authors: Faraci FM,Brian JE Jr

    更新日期:1994-03-01 00:00:00

  • Late measures of brain injury after neonatal hypoxia-ischemia in mice.

    abstract:BACKGROUND AND PURPOSE:This work was undertaken to determine to what degree long-term neurofunctional outcome of neonatal hypoxic-ischemic (HI) brain injury in mice correlates with anatomical extent of cerebral damage assessed by magnetic resonance imaging (MRI) and histopathology. METHODS:On postnatal day 7, mice wer...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000137768.25203.df

    authors: Ten VS,Wu EX,Tang H,Bradley-Moore M,Fedarau MV,Ratner VI,Stark RI,Gingrich JA,Pinsky DJ

    更新日期:2004-09-01 00:00:00

  • Acute changes in intracranial pressure and pressure-volume index after forebrain ischemia in normoglycemic and hyperglycemic rats.

    abstract:BACKGROUND AND PURPOSE:Hyperglycemia enhances the deleterious effect of global cerebral ischemia. One possible explanation is that increased anaerobic glycolysis leads to exaggeration of intracellular acidosis and increased postischemic edema. To examine the importance of this edema on postischemic cerebral perfusion d...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.8.1405

    authors: Morimoto Y,Morimoto Y,Warner DS,Pearlstein RD

    更新日期:1996-08-01 00:00:00

  • Synergistic effects of citicoline and MK-801 in temporary experimental focal ischemia in rats.

    abstract:BACKGROUND AND PURPOSE:Citicoline, a naturally occurring precursor of phosphatidylcholine, is neuroprotective and is currently being assessed in clinical trials. To evaluate potential synergistic neuroprotective effects of prolonged citicoline treatment and early N-methyl-D-aspartate (NMDA) antagonist therapy, suboptim...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.5.1060

    authors: Onal MZ,Li F,Tatlisumak T,Locke KW,Sandage BW Jr,Fisher M

    更新日期:1997-05-01 00:00:00

  • Prestroke Disability Predicts Adverse Poststroke Outcome: A Registry-Based Prospective Cohort Study of Acute Stroke.

    abstract::Background and Purpose- Information on what effect disability before stroke can have on stroke outcome is lacking. We assessed prestroke disability in relation to poststroke hospital outcome. Methods- Analysis of prospectively collected data from the Sentinel Stroke National Audit Programme. A total of 1656 men (mean ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.027740

    authors: Han TS,Fry CH,Gulli G,Affley B,Robin J,Irvin-Sellers M,Fluck D,Kakar P,Sharma S,Sharma P

    更新日期:2020-02-01 00:00:00

  • Intakes of potassium, magnesium, and calcium and risk of stroke.

    abstract:BACKGROUND AND PURPOSE:We aimed to investigate the associations of dietary and total potassium, magnesium, and calcium intakes with stroke occurrence. METHODS:A prospective cohort study was conducted among 36 094 participants aged 21 to 70 years. Dietary intake was assessed with a food frequency questionnaire. RESULT...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.004032

    authors: Sluijs I,Czernichow S,Beulens JW,Boer JM,van der Schouw YT,Verschuren WM,Grobbee DE

    更新日期:2014-04-01 00:00:00

  • The importance of size: successful recanalization by intravenous thrombolysis in acute anterior stroke depends on thrombus length.

    abstract:BACKGROUND AND PURPOSE:We hypothesize that in acute middle cerebral artery stroke, thrombus lengths measured in thin-slice nonenhanced CT images define a limit beyond which systemic thrombolysis will fail to recanalize occluded arteries. METHODS:In 138 patients who presented with acute middle cerebral artery stroke an...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.609693

    authors: Riedel CH,Zimmermann P,Jensen-Kondering U,Stingele R,Deuschl G,Jansen O

    更新日期:2011-06-01 00:00:00

  • Estimation of error limits for cerebral blood flow values obtained from xenon-133 clearance curves.

    abstract::I provide the theoretical basis for an error calculus for measurements of cerebral blood flow using a freely diffusible tracer substance such as xenon-133. The use of the error calculus is exemplified by a study of the effect on the error margins in measurements of gray matter blood flow from flow level, relative weig...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.2.205

    authors: Ryding E

    更新日期:1989-02-01 00:00:00

  • Detection of microembolic signals in patients with middle cerebral artery stenosis by means of a bigate probe. A pilot study.

    abstract:BACKGROUND AND PURPOSE:Middle cerebral artery (MCA) stenosis is a relatively rare occlusive disease with an annual stroke risk of approximately 7% to 8%. However, the frequent coincidence of cardiac or ipsilateral carotid artery disease may lead to difficulties in identifying the relevant embolizing source in symptomat...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.8.1347

    authors: Nabavi DG,Georgiadis D,Mumme T,Zunker P,Ringelstein EB

    更新日期:1996-08-01 00:00:00

  • Anterior choroidal artery territory infarcts. Study of presumed mechanisms.

    abstract:BACKGROUND AND PURPOSE:A previous study suggested that occlusive diseases of small penetrating arteries account for most anterior choroidal artery (AChA) territory infarcts, but half of the patients did not have an echocardiogram. Cases of AChA territory infarcts associated with internal carotid artery stenosis or atri...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.4.837

    authors: Leys D,Mounier-Vehier F,Lavenu I,Rondepierre P,Pruvo JP

    更新日期:1994-04-01 00:00:00

  • Vascular Tissue-Type Plasminogen Activator Promotes Intracranial Aneurysm Formation.

    abstract:BACKGROUND AND PURPOSE:Although the mechanisms that contribute to intracranial aneurysm (IA) formation and rupture are not totally elucidated, inflammation and matrix remodeling are incriminated. Because tPA (tissue-type plasminogen activator) controls both inflammatory and matrix remodeling processes, we hypothesized ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.117.017305

    authors: Labeyrie PE,Goulay R,Martinez de Lizarrondo S,Hébert M,Gauberti M,Maubert E,Delaunay B,Gory B,Signorelli F,Turjman F,Touzé E,Courthéoux P,Vivien D,Orset C

    更新日期:2017-09-01 00:00:00

  • Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators.

    abstract:BACKGROUND AND PURPOSE:Stroke risk increases with age in patients who have nonvalvular atrial fibrillation. It is uncertain whether the efficacy of stroke prevention therapies in atrial fibrillation changes as patients age. The objective of this study was to determine the effect of age on the relative efficacy of oral ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.526988

    authors: van Walraven C,Hart RG,Connolly S,Austin PC,Mant J,Hobbs FD,Koudstaal PJ,Petersen P,Perez-Gomez F,Knottnerus JA,Boode B,Ezekowitz MD,Singer DE

    更新日期:2009-04-01 00:00:00

  • Delirium in an Acute Stroke Setting, Occurrence, and Risk Factors.

    abstract::Background and Purpose- Delirium is a common and serious complication of acute illness. We describe delirium occurrence in an unselected, acute stroke population. Methods- We collected data from consecutive stroke admissions. We performed comprehensive cognitive assessment within the first week including Diagnostic St...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/STROKEAHA.119.025993

    authors: Shaw R,Drozdowska B,Taylor-Rowan M,Elliott E,Cuthbertson G,Stott DJ,Quinn TJ

    更新日期:2019-11-01 00:00:00

  • Better Collaterals Are Independently Associated With Post-Thrombolysis Recanalization Before Thrombectomy.

    abstract::Background and Purpose- In acute stroke patients with large vessel occlusion, the goal of intravenous thrombolysis (IVT) is to achieve early recanalization (ER). Apart from occlusion site and thrombus length, predictors of early post-IVT recanalization are poorly known. Better collaterals might also facilitate ER, for...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.118.022815

    authors: Seners P,Roca P,Legrand L,Turc G,Cottier JP,Cho TH,Arquizan C,Bracard S,Ozsancak C,Ben Hassen W,Naggara O,Lion S,Debiais S,Berthezene Y,Costalat V,Richard S,Magni C,Mas JL,Baron JC,Oppenheim C

    更新日期:2019-04-01 00:00:00

  • Relationship of somatosensory evoked potentials and cerebral oxygen consumption during hypoxic hypoxia in dogs.

    abstract::The effects of hypoxic hypoxia on cerebral hemodynamics and somatosensory evoked potential (SEP) were studied in 10 pentobarbital anestheteized dogs. Cerebral blood flow (CBF) was measured using the venous outflow technique and cerebral oxygen consumption (CMRO2) was calculated from the arterio-cerebro-venous oxygen d...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.17.1.30

    authors: McPherson RW,Zeger S,Traystman RJ

    更新日期:1986-01-01 00:00:00

  • Occurrence and mechanisms of occlusion of the anterior cerebral artery.

    abstract::Occlusion of the anterior cerebral artery is a rare condition. A review of CT scans from 413 patients with ischemic infarction confirmed this low relative incidence: only 3% of CT scans evidencing infarction involved the territory of the anterior cerebral artery. Four major mechanisms of anterior cerebral artery occlu...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.14.6.952

    authors: Gacs G,Fox AJ,Barnett HJ,Vinuela F

    更新日期:1983-11-01 00:00:00

  • Sarcoidosis presenting with stroke.

    abstract::A 25-year-old black man with sarcoidosis presented with transient ischemic attacks followed by sudden, persistent right hemiparesis. He gave a history of recent, recurrent lower motor neuron facial palsy. Computed tomography demonstrated an infarct in the left internal capsule. Chest x-ray film showed bilateral hilar ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.3.400

    authors: Brown MM,Thompson AJ,Wedzicha JA,Swash M

    更新日期:1989-03-01 00:00:00

  • Quantitative carotid phonoangiography.

    abstract::One hundred and sixteen carotid artery bruits were assessed using quantitative phonoangiography (spectral bruit analysis - SBA). This technique uses the averaged break frequency of the bruit to calculate the diameter of he residual lumen at the site of stenosis. Biplanar contrast arteriography was performed on 43 (37%...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.12.6.798

    authors: Knox R,Breslau P,Strandness DE Jr

    更新日期:1981-11-01 00:00:00

  • Survival and recurrence following stroke. The Framingham study.

    abstract::Survival and recurrences after stroke were assessed prospectively in a general population sample of 5184 subjects followed biennially for 26 years. Initial strokes occurred in 198 men and 196 women. There were 84 second and 27 third strokes and 223 deaths reported. Thirty day case-fatality rates for initial strokes we...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.13.3.290

    authors: Sacco RL,Wolf PA,Kannel WB,McNamara PM

    更新日期:1982-05-01 00:00:00

  • NMR-neuropathologic correlation in stroke.

    abstract::True, three-dimensional proton nuclear magnetic resonance imaging at 0.147 tesla was performed postmortem on 2 patients embodying various stroke syndromes, including chronic (4 and 15 years) infarction, subacute (within 1 week) bland infarction, acute (2 days) hemorrhagic infarction, and hematoma secondary to ruptured...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.2.342

    authors: DeWitt LD,Kistler JP,Miller DC,Richardson EP Jr,Buonanno FS

    更新日期:1987-03-01 00:00:00

  • Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project.

    abstract:BACKGROUND AND PURPOSE:There have been relatively few community-based studies of long-term prognosis after acute stroke. This study aimed to provide precise estimates of the absolute and relative risks of dying in an unselected cohort of patients with a first-ever stroke. METHODS:Six hundred seventy-five patients were...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.6.796

    authors: Dennis MS,Burn JP,Sandercock PA,Bamford JM,Wade DT,Warlow CP

    更新日期:1993-06-01 00:00:00

  • Race/ethnicity and location of stroke mortality: implications for population-based studies.

    abstract:BACKGROUND AND PURPOSE:Stroke community surveillance projects often focus on hospital data rates. We hypothesized that not including strokes which occurred in nursing homes or at home would differentially affect race/ethnic stroke rates. METHODS:Texas vital statistics data were studied to compare age-specific (45 to 5...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.30.8.1501

    authors: Wein TH,Smith MA,Morgenstern LB

    更新日期:1999-08-01 00:00:00

  • Persantine Aspirin Trial in cerebral ischemia. Part II: Endpoint results. The American-Canadian Co-Operative Study group.

    abstract::The Persantine Aspirin Trial focused on the question of whether the administration of the combination of aspirin and dipyridamole (Persantine) would result in a lower incidence of cerebral or retinal infarction or death than the administration of aspirin alone for persons with a history of recent carotid territory tra...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.str.16.3.406

    authors:

    更新日期:1985-05-01 00:00:00