We read the recently-published article by Schevin et al. [
[1]
] with great interest. We commended the authors for looking into the work flow in
Emergency Departments (ED) in patients with acute ischemia from large vessel occlusion
(AIS-LVO) to assess where the longest delays to thrombectomy might occur. Unfortunately,
this study is significantly underpowered to comment on patient outcomes. In this retrospective
study of 95 patients undergoing mechanical thrombectomy (MT), the authors showed that
patients' total ED length of stay and successful MT were not associated with good
neurological outcome, defined as 90-day modified Rankin Score (mRS 3–6). The authors
stated that their inability to find difference in outcomes according to delays to
thrombectomy “suggests that faster transfer might not be necessarily better in all
cases, but speed of transfer should be weighed against the potential need for additional
evaluation and alternative diagnoses.”- Scheving W.L.
- Froehler M.
- Hart K.
- Mcnaughton C.D.
- Ward M.J.
Inter-facility transfer for patients with acute large vessel occlusion stroke receiving
mechanical thrombectomy.
Am J Emerg Med. 2020; (September (22): Online ahead of print)https://doi.org/10.1016/j.ajem.2020.09.041
Keywords
To read this article in full you will need to make a payment
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy.Am J Emerg Med. 2020; (September (22): Online ahead of print)https://doi.org/10.1016/j.ajem.2020.09.041
- Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: ameta-analysis.J Am Med Assoc. 2016; 316: 1279-1288https://doi.org/10.1001/jama.2016.13647
- Time to endovascular treatment and outcome in acute ischemic stroke: MR CLEAN registry results.Circulation. 2018; 138: 232-240https://doi.org/10.1161/CIRCULATIONAHA.117.032600
- Fast versus slow progressors of infarct growth in large vessel occlusion stroke: clinical and research implications.Stroke. 2017; 48: 2621-2627https://doi.org/10.1161/STROKEAHA.117.017673
- Interfacility Transfer Directly to the Neuroangiography Suite in Acute Ischemic Stroke Patients Undergoing.2017: 1884-1890https://doi.org/10.1161/STROKEAHA.117.016946
- Comparison of outcomes after treatment of large vessel occlusion in a critical care resuscitation unit or a neurocritical care unit.Neurocrit Care. 2020; 32: 725-733https://doi.org/10.1007/s12028-019-00825-1
- Bypassing the Closest Stroke Center for Thrombectomy Candidates What Additional Delay to Thrombolysis Is Acceptable?.2020: 867-875https://doi.org/10.1161/STROKEAHA.119.027512
- Transport blood pressures and outcomes in stroke patients requiring thrombectomy.Air Med J. 2020; 39: 166-172https://doi.org/10.1016/j.amj.2020.03.002
- Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct.N Engl J Med. 2018; 378: 11-21https://doi.org/10.1056/NEJMoa1706442
- Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging.N Engl J Med. 2018; 378: 708-718https://doi.org/10.1056/NEJMoa1713973
Article Info
Publication History
Published online: November 25, 2020
Accepted:
November 23,
2020
Received:
November 7,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
