title: A Mobile Stroke Treatment Unit for Field Triage of Patients for Intraarterial Revascularization Therapy.
abstract: BACKGROUND
  Favorable outcomes in intraarterial therapy (IAT) for acute ischemic stroke (AIS) are related to early vessel recanalization. The mobile stroke treatment unit (MSTU) is an on-site, prehospital, treatment team, laboratory, and CT scanner that reduces time to treatment for intravenous thrombolysis and may also shorten time to IAT.
  
  
  METHODS
  Using our MSTU database, we identified patients that underwent IAT for AIS. We compared the key time metrics to historical controls, which included patients that underwent IAT at our institution six months prior to implementation of the MSTU. We further divided the controls into two groups: (1) transferred to our institution for IAT and (2) directly presented to our emergency room and underwent IAT.
  
  
  RESULTS
  After 164 days of service, the MSTU transported 155 patients of which 5 underwent IAT. We identified 5 historical controls that were transferred to our center for IAT. Substantial reduction in times including median door to initial CT (12 minute vs. 32 minute), CT to IAT (82 minute vs. 165 minute), and door to MSTU/primary stroke center departure (37 minute vs. 106 minute) were noted among the two groups. Compared to the 6 patients who presented to our institution directly, the MSTU process times were also shorter.
  
  
  CONCLUSIONS
  Our initial experience shows that MSTU may help in early triage and shorten the time to IAT for AIS.
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Russell
authors.initials: R
authors.lastname: Cerejo
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Seby
authors.initials: S
authors.lastname: John
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Buletko
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Ather
authors.initials: A
authors.lastname: Taqui
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Itrat
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH.
authors.forename: Natalie
authors.initials: N
authors.lastname: Organek
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH.
authors.forename: Sung-Min
authors.initials: SM
authors.lastname: Cho
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH.
authors.forename: Lila
authors.initials: L
authors.lastname: Sheikhi
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Ken
authors.initials: K
authors.lastname: Uchino
authors.affiliation: Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH.
authors.forename: Farren
authors.initials: F
authors.lastname: Briggs
authors.affiliation: Critical Care Transport Team, Cleveland Clinic, Cleveland, OH.|Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Reimer
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Stacey
authors.initials: S
authors.lastname: Winners
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Gabor
authors.initials: G
authors.lastname: Toth
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Peter
authors.initials: P
authors.lastname: Rasmussen
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Hussain
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis* / Q000188:drug therapy; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014218:Triage / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Mobile Stroke Treatment Unit (MSTU); prehospital emergency care; stroke; thrombectomy