Mobile stroke care expedites intravenous thrombolysis and endovascular thrombectomy

• Published in: Stroke and vascular neurology 2022-06, Vol.7 (3), p.209-214
• Main Authors: Bender, Matthew T, Mattingly, Thomas K, Rahmani, Redi, Proper, Diana, Burnett, Walter A, Burgett, Jason L, LEsperance, Joshua, Cushman, Jeremy T, Pilcher, Webster H, Benesch, Curtis G, Kelly, Adam G, Bhalla, Tarun
• Format: Article
• Language: English
• Subjects: Clinical outcomes; Emergency services; Original Research; Patients; Statistical analysis; Stroke; thrombectomy; Thrombolytic drugs; thrombolytic therapy; Transient ischemic attack
• ISSN: 2059-8688; 2059-8696
• DOI: 10.1136/svn-2021-001119

BackgroundThe number of mobile stroke programmes has increased with evidence, showing they expedite intravenous thrombolysis. Outstanding questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical outcomes.ObjectiveOur mobile stroke unit (MSU), based at an academic medical centre in upstate New York, launched in October 2018. We reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service (EMS) patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical outcomes.ResultsOver 568 days in service, the MSU was dispatched 1489 times (2.6/day) and transported 300 patients (20% of dispatches). Intravenous tissue plasminogen activator (tPA) was administered to 57 MSU patients and the average time from 911 call-to-tPA was 42.5 min (±9.2), while EMS transported 73 patients who received tPA at 99.4 min (±35.7) (p