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Efficacy of 'drive and retrieve' as a cooperative method for prompt endovascular treatment for acute ischemic stroke

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Title: Efficacy of 'drive and retrieve' as a cooperative method for prompt endovascular treatment for acute ischemic stroke
Authors: Osanai, Toshiya Browse this author →KAKEN DB
Ito, Yasuhiro Browse this author
Ushikoshi, Satoshi Browse this author
Aoki, Takeshi Browse this author
Kawabori, Masahito Browse this author →KAKEN DB
Fujiwara, Kensuke Browse this author
Ogasawara, Katsuhiko Browse this author →KAKEN DB
Tokairin, Kikutaro Browse this author
Maruichi, Katsuhiko Browse this author
Nakayama, Naoki Browse this author →KAKEN DB
Ono, Kota Browse this author →KAKEN DB
Houkin, Kiyohiro Browse this author →KAKEN DB
Kazumata, Ken Browse this author →KAKEN DB
Keywords: thrombectomy
Issue Date: Aug-2019
Publisher: BMJ Publishing Group
Journal Title: Journal of Neurointerventional Surgery
Volume: 11
Issue: 8
Start Page: 757
End Page: 761
Publisher DOI: 10.1136/neurintsurg-2018-014296
Abstract: Background Outcomes of endovascular treatment for acute ischemic stroke depend on the time interval from onset to reperfusion. Although the centralized 'mothership' method is considered preferable, the required transportation time increases the risk that a patient with a stroke may not receive intravenous or endovascular therapy. In contrast, 'drive and retrieve' describes a system wherein doctors from comprehensive stroke centers travel to primary stroke centers and provide endovascular treatment for acute ischemic stroke. Objective To describe the drive and retrieve system and verify the effects of this new collaboration on outcomes in patients with acute ischemic stroke among facilities. Methods This non-randomized, single-arm study retrospectively analyzed patients who met the inclusion criteria for endovascular treatment provided through a drive and retrieve system. Among the 122 patients treated by this system, we analyzed the time of onset to recanalization as the primary outcome. We also analyzed the efficacy of the drive and retrieve system using geographic information system analysis. Results The median time from onset to recanalization was 229 min (IQR 170-307 min, 95% CI 201 to 252 min). The upper limit of the 95% CI for the time from onset to recanalization was shorter than the median times reported in two previous trials. Geographic information system analysis revealed an upward trend in the population coverage rate in each secondary medical area after the drive and retrieve method was introduced. Conclusion The drive and retrieve method may be an effective form of cooperation between facilities located within 1 hour of a comprehensive stroke center.
Rights: This article has been accepted for publication in Journal of NeuroInterventional Surgery, 2019 following peer review, and the Version of Record can be accessed online at c Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 長内 俊也

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