Abstract
Abstract only
Introduction:
Emergent Large Vessel Occlusion (ELVO) has low recanalization rates with intravenous tissue plasminogen activator (IV tPA). Ultra-early treatment with IV tPA, however, may lead to higher recanalization rates. Mobile stroke units (MSUs) have been shown to reduce treatment times. We compared the recanalization rates of ELVO patients treated on our MSUs against those treated in the traditional emergency department (ED) setting.
Methods:
We reviewed patients from two MSU programs who were identified to have ELVO treated either in the ED or on the MSU from August 2014 to July 2017. Demographics, imaging characteristics, times to treatment, and recanalization rates were collected and analyzed. Statistical comparison was performed utilizing chi-squared and t-tests.
Results:
One hundred ninety (34 treated on MSU, 156 treated in the ED) ELVO patients were included in the analysis. Baseline characteristics including age (70 years MSU vs. 66 years in ED); sex (MSU 50% female vs. ED 46.8% female) and vessel occlusion location (ICA: MSU 23.5% vs. ED 25.2%; MCA: MSU 67.6% vs. ED 66.9%) were similar between the two groups. However, the MSU group had a higher initial median National Institutes of Health Stroke Scale (NIHSS) score (15.5 vs. 11.6; p = 0.01). The MSU group also had a shorter time from stroke onset to treatment (70 minutes vs. 126 minutes; p = 0.001). Recanalization of ELVO was seen more frequently on the MSU as compared to in the ED (29.4% vs. 22%; p=0.04).
Conclusion:
Higher recanalization rate of ELVO was observed with thrombolysis on mobile stroke units as compared to the emergency department.