Cargando…

Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion

Background The outcome of mechanical thrombectomy for large vessel occlusion (LVO) in patients with acute ischemic stroke (AIS) is time-dependent. In the current stroke workflow, the pre-hospital delay is one of the most common reasons for an increase in door-to-groin puncture time (DGPT). In the pr...

Descripción completa

Detalles Bibliográficos
Autores principales: Farooqui, Mudassir, Suriya, Sajid, Quadri, Syed, Baig, Aqsa, Khalil, Mohammad Hamza, Liaquat, Ayesha, Taqi, Asif
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506579/
https://www.ncbi.nlm.nih.gov/pubmed/36168340
http://dx.doi.org/10.7759/cureus.28348
_version_ 1784796758052700160
author Farooqui, Mudassir
Suriya, Sajid
Quadri, Syed
Baig, Aqsa
Khalil, Mohammad Hamza
Liaquat, Ayesha
Taqi, Asif
author_facet Farooqui, Mudassir
Suriya, Sajid
Quadri, Syed
Baig, Aqsa
Khalil, Mohammad Hamza
Liaquat, Ayesha
Taqi, Asif
author_sort Farooqui, Mudassir
collection PubMed
description Background The outcome of mechanical thrombectomy for large vessel occlusion (LVO) in patients with acute ischemic stroke (AIS) is time-dependent. In the current stroke workflow, the pre-hospital delay is one of the most common reasons for an increase in door-to-groin puncture time (DGPT). In the present study, we sought to compare the difference in (DGPT) before and after the implementation of the Ventura Emergent Large Vessel Occlusion Score (VES) protocol for LVO. Methods VES was implemented in the Ventura County of California by Emergency Medical Services (EMS). We performed a retrospective analysis to compare DGPT of patients undergoing endovascular treatment (EVT) pre- and post-VES implementation. Mean and standard deviation was reported for the continuous variable ‘time for intra-arterial (IA) treatment’ in minutes. The Mann-Whitney test was used for the comparison of the variable between the two groups. analyses were performed using SAS v9.4 (SAS Institute Inc., Cary, NC) with a significant p-value of ≤0.05. Results A total of 304 (males: 142 and females: 162) patients were alerted of the stroke code by the EMS. VES was positive in 139 patients. Of these, 64 (46%) were males and 75 (54%) were females. VES score of 1, 2, 3, and 4 were recorded in 57 (41%), 44 (31.6%), 31 (22.3%), and 7 (5%) patients, respectively. A total of 48 VES-positive patients underwent EVT. There were 62 patients who underwent EVT before the implementation of the VES protocol. The mean DGPT for the EVT among post-VES patients was 65 minutes, which was significantly (p=0.0009) shorter than the mean DGPT of 109 minutes among pre-VES patients. Conclusion VES is a simplified and effective tool for identifying LVO in the field. Implementation of VES showed significantly reduced DGPT in LVO patients.
format Online
Article
Text
id pubmed-9506579
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-95065792022-09-26 Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion Farooqui, Mudassir Suriya, Sajid Quadri, Syed Baig, Aqsa Khalil, Mohammad Hamza Liaquat, Ayesha Taqi, Asif Cureus Emergency Medicine Background The outcome of mechanical thrombectomy for large vessel occlusion (LVO) in patients with acute ischemic stroke (AIS) is time-dependent. In the current stroke workflow, the pre-hospital delay is one of the most common reasons for an increase in door-to-groin puncture time (DGPT). In the present study, we sought to compare the difference in (DGPT) before and after the implementation of the Ventura Emergent Large Vessel Occlusion Score (VES) protocol for LVO. Methods VES was implemented in the Ventura County of California by Emergency Medical Services (EMS). We performed a retrospective analysis to compare DGPT of patients undergoing endovascular treatment (EVT) pre- and post-VES implementation. Mean and standard deviation was reported for the continuous variable ‘time for intra-arterial (IA) treatment’ in minutes. The Mann-Whitney test was used for the comparison of the variable between the two groups. analyses were performed using SAS v9.4 (SAS Institute Inc., Cary, NC) with a significant p-value of ≤0.05. Results A total of 304 (males: 142 and females: 162) patients were alerted of the stroke code by the EMS. VES was positive in 139 patients. Of these, 64 (46%) were males and 75 (54%) were females. VES score of 1, 2, 3, and 4 were recorded in 57 (41%), 44 (31.6%), 31 (22.3%), and 7 (5%) patients, respectively. A total of 48 VES-positive patients underwent EVT. There were 62 patients who underwent EVT before the implementation of the VES protocol. The mean DGPT for the EVT among post-VES patients was 65 minutes, which was significantly (p=0.0009) shorter than the mean DGPT of 109 minutes among pre-VES patients. Conclusion VES is a simplified and effective tool for identifying LVO in the field. Implementation of VES showed significantly reduced DGPT in LVO patients. Cureus 2022-08-24 /pmc/articles/PMC9506579/ /pubmed/36168340 http://dx.doi.org/10.7759/cureus.28348 Text en Copyright © 2022, Farooqui et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Farooqui, Mudassir
Suriya, Sajid
Quadri, Syed
Baig, Aqsa
Khalil, Mohammad Hamza
Liaquat, Ayesha
Taqi, Asif
Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion
title Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion
title_full Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion
title_fullStr Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion
title_full_unstemmed Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion
title_short Reduction in Door-to-Groin Puncture Time for Endovascular Treatment in Acute Ischemic Stroke Patients With Large Vessel Occlusion
title_sort reduction in door-to-groin puncture time for endovascular treatment in acute ischemic stroke patients with large vessel occlusion
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506579/
https://www.ncbi.nlm.nih.gov/pubmed/36168340
http://dx.doi.org/10.7759/cureus.28348
work_keys_str_mv AT farooquimudassir reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion
AT suriyasajid reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion
AT quadrisyed reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion
AT baigaqsa reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion
AT khalilmohammadhamza reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion
AT liaquatayesha reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion
AT taqiasif reductionindoortogroinpuncturetimeforendovasculartreatmentinacuteischemicstrokepatientswithlargevesselocclusion