'Stroke Room': Diagnosis and Treatment at a Single Location for Rapid Intraarterial Stroke Treatment.
BACKGROUND
For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment.


METHODS
Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room').


RESULTS
After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed.


CONCLUSIONS
This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT.
Department of Neurology, University of the Saarland, Homburg, Germany.
Andreas
A
Ragoschke-Schumm
Umut
U
Yilmaz
Panagiotis
P
Kostopoulos
Martin
M
Lesmeister
Matthias
M
Manitz
Silke
S
Walter
Stefan
S
Helwig
Lenka
L
Schwindling
Mathias
M
Fousse
Anton
A
Haass
Dominique
D
Garner
Heiko
H
Körner
Safwan
S
Roumia
Iris
I
Grunwald
Ali
A
Nasreldein
Ramona
R
Halmer
Yang
Y
Liu
Thomas
T
Schlechtriemen
Wolfgang
W
Reith
Klaus
K
Fassbender
D000208:Acute Disease; D000368:Aged; D002533:Cerebral Angiography; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006757:Hospital Units / Q000458:organization & administration*; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000628:therapy*; D062606:Tertiary Care Centers / Q000458:organization & administration; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D061665:Time-to-Treatment; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator