title: Safety and Effectiveness of Drip, Ship, and Retrieve Paradigm for Acute Ischemic Stroke: a Single Center Experience.
abstract: This study analyzed the efficacy and safety of the "drip, ship, and retrieve (DSR)" approach used to improve patient access to thrombectomy for acute stroke.
  
  
  METHODS
  The study participants were 45 patients who underwent thrombectomy following intravenous tissue plasminogen activator between September 2013 and August 2015. Patients were divided into two groups according to whether they were transferred from another hospital (DSR group; n = 33) or were brought in directly (Direct group; n = 12). The two groups were compared based on their baseline characteristics, time from stroke onset to reperfusion, outcome, and adverse events.
  
  
  RESULTS
  There were no significant differences in baseline characteristics. Time from onset until admission to our facility was significantly shorter in the Direct group (56.9 min) than in the DSR group (163.5 min) (P <0.0001). Conversely, time from arrival at the hospital to arterial puncture was significantly shorter in the DSR group (25.0 min) than in the Direct group (109.5 min) (P <0.0001). Time from onset to reperfusion did not differ significantly between the groups. There was no significant difference in patient outcomes, with a modified Rankin scale score of 0-2 (44.8% in DSR group versus 48.7% in Direct group). Moreover, there was no difference in the incidence of adverse events.
  
  
  CONCLUSIONS
  Despite the time required to transfer patients in the DSR group between hospitals, reducing the time from arrival until commencement of endovascular therapy meant that the time from onset to reperfusion was approximately equivalent to that of the Direct group.
  
  
  CONCLUSIONS
  Time-saving measures need to be taken by both the transferring and receiving hospitals in DSR paradigm.
authors.affiliation: Department of Neurosurgery, Hyogo College of Medicine.
authors.forename: Nagayasu
authors.initials: N
authors.lastname: Hiyama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshimura
authors.forename: Manabu
authors.initials: M
authors.lastname: Shirakawa
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Uchida
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Oki
authors.forename: Seigo
authors.initials: S
authors.lastname: Shindo
authors.forename: Kou
authors.initials: K
authors.lastname: Tokuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents; D006801:Humans; D008297:Male; D010360:Patient Transfer; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents