Effect of the Use of Ambulance-Based Thrombolysis on Time to Thrombolysis in Acute Ischemic Stroke

Ebinger, Martin; Winter, Benjamin; Wendt, Matthias; Weber, Joachim E.; Waldschmidt, Carolin; Różański, Michał; Kunz, Alexander; Koch, Peter; Kellner, Philipp; Gierhake, Daniel; Villringer, Kersten; Fiebach, Jochen B.; Grittner, Ulrike; Hartmann, Andreas; Mackert, Bruno-Marcel; Endres, Matthias; Audebert, Heinrich J.

doi:10.1001/jama.2014.2850

Cited by 402 publications

(370 citation statements)

References 23 publications

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“…The Prehospital Acute Neurological Treatment and Optimization of Medical care in Stroke Study (PHANTOM-S) in Germany reported their MSTU significantly decreased stroke alert-to-treatment times from 76 minutes to 52 minutes, and significantly increased thrombolysis rates from 21% to 33% with no increase in the risk of intracerebral hemorrhage. 15 Among patients receiving thrombolytic therapy, the same German group also reported the proportion of so-called "golden-hour thrombolysis" was 6-fold higher with MSTU deployment.…”

Section: Mobile Stroke Treatment Unitsmentioning

confidence: 97%

Application of emerging technologies to improve access to ischemic stroke care

Vuong

Carroll

Tackla

et al. 2017

Neurosurgical Focus

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During the past 20 years, the traditional supportive treatment for stroke has been radically transformed by advances in catheter technologies and a cohort of prominent randomized controlled trials that unequivocally demonstrated significant improvement in stroke outcomes with timely endovascular intervention. However, substantial limitations to treatment remain, among the most important being timely access to care. Nonetheless, stroke care has continued its evolution by incorporating technological advances from various fields that can further reduce patients' morbidity and mortality. In this paper the authors discuss the importance of emerging technologies—mobile stroke treatment units, telemedicine, and robotically assisted angiography—as future tools for expanding access to the diagnosis and treatment of acute ischemic stroke.

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Section: Mobile Stroke Treatment Unitsmentioning

confidence: 97%

Application of emerging technologies to improve access to ischemic stroke care

Vuong

Carroll

Tackla

et al. 2017

Neurosurgical Focus

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“…The Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke Study showed that the time from notification to treatment was reduced by 25 minutes and the rate of thrombolysis increased by 12% in patients treated by an MSU when compared with standard EMS care. 10 The study also did not report any increases in adverse effects due to tPA administration when compared with traditional treatment. Another controlled study in Saarland, Germany, showed that the use of MSUs allowed a reduction of 41 minutes in the median time needed to make a therapeutic decision from alarm to therapy (35 minutes with MSU vs 76 minutes with regular care).…”

Section: Mobile Stroke Unitsmentioning

confidence: 85%

“…4,10,15,16,29,35,37,41,44 The greatest delay in the treatment of stroke patients has been shown to be in the prehospital phase, in which the patient is transported to a stroke specialty facility. 21 In an effort to combat this delay, the concept of the MSU was developed.…”

Section: Mobile Stroke Unitsmentioning

confidence: 99%

Expanding the treatment window for ischemic stroke through the application of novel system-based technology

El‐Ghanem¹,

Al‐Mufti²,

Thulasi

et al. 2017

FOC

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Recent randomized controlled trials have demonstrated the superiority of endovascular treatment (ET) over medical management in the treatment of acute ischemic stroke patients with anterior circulation emergent large vessel occlusions (ELVOs). Due to such accumulating evidence, expanding ET has become of paramount importance. Advancements in modern technology have enabled the use of mobile stroke units, telestroke networks, mobile neuroendovascular teams, and smartphone applications that shorten the time window to treatment and, thus, make patients more amenable to ET. Additionally, modifying stroke-screening tools to make them more accessible to first responders and the creation of stroke registries can provide further opportunities for ET.

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“…Pilotstudier med CT-utstyrt hjerneslagambulanse har vaert gjennomført i Tyskland (Ebinger, Winter & Wendt, 2014 ten. I Alta er det også naturlig at en CT-maskin lokaliseres ved legevakten.…”

Section: Status Og Utfordringerunclassified