Feasibility, Safety, and Technical Success of the Flying Intervention Team in Acute Ischemic Stroke
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Published:2022-11-02
Issue:
Volume:
Page:
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ISSN:1869-1439
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Container-title:Clinical Neuroradiology
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language:en
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Short-container-title:Clin Neuroradiol
Author:
Kettner Alexander, Schlachetzki Felix, Boeckh-Behrens Tobias, Zimmer Claus, Wunderlich Silke, Kraus Frank, Haberl Roman Ludwig, Hubert Gordian Jan, Boy Sandra, Henninger Julia, Friedrich Benjamin, Maegerlein ChristianORCID
Abstract
Abstract
Background
Prompt endovascular care of patients with ischemic stroke due to large vessel occlusion (LVO) remains a major challenge in rural regions as primary stroke centers (PSC) usually cannot provide neuro-interventional services. Objective The core content of the Flying Intervention Team (FIT) project is to perform thrombectomy on-site at a local PSC after the neuro-interventionalist has been transported via helicopter to the target hospital. An important and so far unanswered question is whether mechanical thrombectomy can be performed as safely and successfully on-site as in a specialized comprehensive stroke center (CSC).
Methods
Comparison of 100 FIT thrombectomies on site in 14 different PSCs with 128 control thrombectomies at 1 CSC (79 drip-and-ship, 49 mothership) performed by a single interventionalist with respect to technical-procedural success parameters, procedural times, and complications.
Results
There were no significant differences between the two groups in terms of technical success (95.0% successful interventions in FIT group vs. 94.5% in control group, p = 0.60) and complications (3% major complications in FIT vs. 1.6% in control group, p = 0.47). Regarding time from onset to groin puncture, there was no difference between FIT and the entire control group (182 vs. 183 min, p = 0.28), but a trend in favor of FIT compared with the drip-and-ship control subgroup (182 vs. 210 min, p = 0.096).
Conclusions
Airborne neuro-interventional thrombectomy service is a feasible approach for rural regions. If performed by experienced neuro-interventionalists, technical success and complication rates are comparable to treatment in a specialized neuro-interventional department.
Funder
Klinikum rechts der Isar der Technischen Universität München
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),Radiology, Nuclear Medicine and imaging
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