Identifying delays to mechanical thrombectomy for acute stroke: onset to door and door to clot times.
Outcomes from endovascular therapy for acute stroke are time dependent. Delays in the administration of this therapy have not been extensively studied and no performance benchmarks have been established. There are limited data on the complex factors that can affect these delays. In this review, we discuss the existing literature on the delays involved in endovascular therapy and have presented them as prehospital and inhospital factors. Some of these factors are common to intravenous thrombolysis; in addition, there are some that are unique to endovascular therapy. These include the awareness of the first responders, emergency medical services, interhospital transfer and triage systems, activation of the endovascular team, complex imaging decisions, and intraprocedural delays. A thorough understanding of these delays can help identify areas of improvement which may affect clinical outcomes.
Department of Neurology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin, USA.
Kaiz S
KS
Asif
Department of Neurology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin, USA Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin, USA.
Marc A
MA
Lazzaro
Department of Neurology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin, USA Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin, USA Department of Radiology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin, USA.
Osama
O
Zaidat
D001777:Blood Coagulation; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D057510:Endovascular Procedures / Q000706:statistics & numerical data*; D006801:Humans; D010360:Patient Transfer; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy / Q000706:statistics & numerical data*; D061665:Time-to-Treatment
Stroke; Thrombectomy