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• W4367304086 abstract "<h3>Objective:</h3> Evaluate the impact of a direct-to-angiosuite (DTAS) workflow on Mobile Stroke Units (MSU) in stroke patients with large vessel occlusions (LVO) needing mechanical thrombectomy (MT). <h3>Background:</h3> MSUs are equipped with CT/CT angiography (CTA), thrombolytics and personnel that can deliver emergency stroke care to patients and reduce time-to-thrombolytic administration and improve clinical outcomes. Although there is no benefit of MSUs on alert-to-puncture times, a reduction in time was seen when CTA was obtained on-board the MSU, which suggests that a DTAS protocol may be a powerful method to reduce delay from alert-to-puncture. <h3>Design/Methods:</h3> The MSU DTAS group will be comprised of suspected LVO patients having CTA on-board the MSU, alerting of the MT team en route, and bypassing the Emergency Department (ED) with direct transport to the angiosuite. The control group will comprise of the standard Emergency Medical Services (EMS) management group from the BEST-MSU study. In those patients, CTA was done after arrival to the ED and then transported to the angiosuite. Primary outcome will be alert-to-puncture time. Secondary outcomes will include 90-day modified Rankin scale and degree of recanalization. Analysis of the mRS will be a propensity-score based ordinal logistic regression adjusted for baseline predictors to estimate the common odds ratio. Based on pilot data, we estimate we will detect at least a 30-minute reduction in alert-to-puncture time. <h3>Results:</h3> In a preliminary analysis of the BEST-MSU study, DTAS management resulted in shorter alert-to-puncture (42 minutes) and door-to-puncture times (50 minutes) with similar safety and clinical outcomes compared with standard management. We plan to enroll additional patients to the MSU DTAS pathway and a more detailed and final analysis will be available upon abstract presentation at the AAN conference. <h3>Conclusions:</h3> A DTAS workflow, triggered by CTA on MSU patients suspected of having LVO, substantially speeds alert-to thrombectomy, and may improve recanalization and clinical outcome. <b>Disclosure:</b> Dr. Tariq has nothing to disclose. Stephanie Parker has nothing to disclose. Dr. Jacob has nothing to disclose. Mengxi Wang has nothing to disclose. Noopur Singh has nothing to disclose. The institution of Jose-Miguel Yamal has received research support from NIH/DoD. Mr. Phan has nothing to disclose. Ms. Bratina has nothing to disclose. Dr. Bowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astrazeneca. Dr. Grotta has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Frazer Ltd. Dr. Grotta has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Haemonetics. Dr. Grotta has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acticor. Dr. Grotta has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Prolong Pharma. The institution of Dr. Grotta has received research support from Genentech. The institution of Dr. Grotta has received research support from CSL Behring. The institution of Dr. Grotta has received research support from Chiesi. Dr. Grotta has received publishing royalties from a publication relating to health care. Dr. Grotta has received publishing royalties from a publication relating to health care. The institution of Dr. Czap has received research support from SVIN. The institution of Dr. Czap has received research support from AAN." @default.
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• W4367304086 date "2023-04-25" @default.
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• W4367304086 title "Optimizing Management and Outcomes of Large Vessel Occlusion Ischemic Stroke Utilizing Mobile Stroke Units (P8-5.002)" @default.
• W4367304086 doi "https://doi.org/10.1212/wnl.0000000000202495" @default.
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