J Korean Med Sci.
2018 May;33(19):e143. 10.3346/jkms.2018.33.e143.
Consensus Statements by Korean Society of Interventional Neuroradiology and Korean Stroke Society: Hyperacute Endovascular Treatment Workflow to Reduce Door-to-Reperfusion Time
- Kim DH
- Kim B
- Jung C
- Nam HS
- Lee JS
- Kim JW
- Lee WJ
- Seo WK
- Heo JH
- Baik SK
- Kim BM
- Rha JH
- on behalf of Korean Society of Interventional Neuroradiology and Korean Stroke Society Joint Task Force Team
- Affiliations
-
- 1Department of Neurology, Dong-A University Hospital, Busan, Korea.
- 2Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
- 3Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
- 4Department of Neurology, Yonsei University Severance Hospital, Seoul, Korea.
- 5Department of Neurology, Ajou University School of Medicine, Suwon, Korea.
- 6Department of Radiology, Inje Univeristy Ilsan Paik Hospital, Goyang, Korea.
- 7Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
- 8Department of Neurology, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea.
- 9Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.
- 10Department of Radiology, Yonsei University Severance Hospital, Seoul, Korea. bmoon21@hanmail.net
- 11Department of Neurology, Inha University Hospital, Incheon, Korea. jhrha@inha.ac.kr
- KMID: 2410528
- DOI: http://doi.org/10.3346/jkms.2018.33.e143
Abstract
- Recent clinical trials demonstrated the clinical benefit of endovascular treatment (EVT) in patients with acute ischemic stroke due to large vessel occlusion. These trials confirmed that good outcome after EVT depends on the time interval from symptom onset to reperfusion and that in-hospital delay leads to poor clinical outcome. However, there has been no universally accepted in-hospital workflow and performance benchmark for rapid reperfusion. Additionally, wide variety in workflow for EVT is present between each stroke centers. In this consensus statement, Korean Society of Interventional Neuroradiology and Korean Stroke Society Joint Task Force Team propose a standard workflow to reduce door-to-reperfusion time for stroke patients eligible for EVT. This includes early stroke identification and pre-hospital notification to stroke team of receiving hospital in pre-hospital phase, the transfer of stroke patients from door of the emergency department to computed tomography (CT) room, warming call to neurointervention team for EVT candidate prior to imaging, neurointervention team preparation in parallel with thrombolysis, direct transportation from CT room to angiography suite following immediate decision of EVT and standardized procedure for rapid reperfusion. Implementation of optimized workflow will improve stroke time process metrics and clinical outcome of the patient treated with EVT.
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