2023
Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines–Stroke Registry
Raychev R, Sun J, Schwamm L, Smith E, Fonarow G, Messé S, Xian Y, Chiswell K, Blanco R, Mac Grory B, Saver J. Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines–Stroke Registry. Circulation 2023, 148: 2019-2028. PMID: 37855118, DOI: 10.1161/circulationaha.123.066114.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerThrombectomy-capable stroke centersAcute ischemic strokeGuidelines-Stroke registryEndovascular thrombectomyStroke centersReperfusion therapyIschemic strokeClinical outcomesHealth Stroke Scale scoreClinical efficacy outcomesStroke Scale scoreHigher National InstitutesOdds of dischargeGoal doorEVT proceduresHospital mortalityIntravenous thrombolysisEfficacy outcomesSuccessful reperfusionCohort studyDischarge destinationNeedle timePuncture time
2022
In a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes
Kraft A, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Rost N, Leslie-Mazwi T, Patel A, Regenhardt R. In a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes. Interventional Neuroradiology 2022, 29: 315-320. PMID: 35317663, PMCID: PMC10369105, DOI: 10.1177/15910199221087498.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIntravenous thrombolysisIVT-treated patientsMechanical thrombectomyProcedure timePuncture timeImproved reperfusionBaseline characteristicsTICI 2bIVT patientsOcclusion strokeOperative reportsProcedural characteristicsTelestroke networkPatientsReperfusionIncreased proportionThrombolysisTechnical difficultiesNIHSSThrombectomyHospitalStrokeMin
2019
Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice
Jahan R, Saver J, Schwamm L, Fonarow G, Liang L, Matsouaka R, Xian Y, Holmes D, Peterson E, Yavagal D, Smith E. Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. JAMA 2019, 322: 252-263. PMID: 31310296, PMCID: PMC6635908, DOI: 10.1001/jama.2019.8286.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeEndovascular reperfusion therapySymptomatic intracranial hemorrhageLarge vessel occlusionRoutine clinical practiceHospice dischargePuncture timeClinical practiceSubstantial reperfusionIschemic strokeArterial punctureVessel occlusionLarge vessel occlusion acute ischemic strokeMedian pretreatment scoreHealth Stroke ScaleRetrospective cohort studyRandomized clinical trialsHigher likelihoodAssociation of speedAmbulatory statusReperfusion therapyStroke ScaleAdverse eventsCohort studyHospital arrivalComponents and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals
Menon B, Xu H, Cox M, Saver J, Goyal M, Peterson E, Xian Y, Matsuoka R, Jehan R, Yavagal D, Gupta R, Mehta B, Bhatt D, Fonarow G, Schwamm L, Smith E. Components and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals. Circulation 2019, 139: 169-179. PMID: 30586703, DOI: 10.1161/circulationaha.118.036701.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke hospitalsEndovascular therapyHospital-level variablesShorter doorArterial accessCase volumeFirst pass timeArterial puncture timeComprehensive stroke centerLarge vessel occlusionCalendar year quarterWorkflow timesSignificant linear time trendsIschemic strokeLonger doorMedian doorStroke centersArterial punctureDiabetes mellitusMultivariable analysisPuncture timeFaster doorEmergency departmentClinical trialsMultivariable modeling
2018
Protocols for Endovascular Stroke Treatment Diminish the Weekend Effect Through Improvements in Off-Hours Care
Raymond S, Akbik F, Stapleton C, Mehta B, Chandra R, Gonzalez R, Rabinov J, Schwamm L, Patel A, Hirsch J, Leslie-Mazwi T. Protocols for Endovascular Stroke Treatment Diminish the Weekend Effect Through Improvements in Off-Hours Care. Frontiers In Neurology 2018, 9: 1106. PMID: 30619062, PMCID: PMC6305592, DOI: 10.3389/fneur.2018.01106.Peer-Reviewed Original ResearchTime of presentationTreatment latencyTreatment intervalEndovascular stroke treatmentProspective observational cohortOff-hour careAcute strokeMedian doorObservational cohortConsecutive patientsEndovascular therapyStroke treatmentStroke carePuncture timeFunctional outcomeProtocol adherenceThrombolysis candidatesInstitutional protocolPatient outcomesWeekend effectProtocol experienceStudy periodOutcomesPatientsRegular work hours
2014
Reducing Door‐to‐Puncture Times for Intra‐Arterial Stroke Therapy: A Pilot Quality Improvement Project
Mehta B, Leslie‐Mazwi T, Chandra R, Bell D, Sun C, Hirsch J, Rabinov J, Rost N, Schwamm L, Goldstein J, Levine W, Gupta R, Yoo A. Reducing Door‐to‐Puncture Times for Intra‐Arterial Stroke Therapy: A Pilot Quality Improvement Project. Journal Of The American Heart Association 2014, 3: e000963. PMID: 25389281, PMCID: PMC4338685, DOI: 10.1161/jaha.114.000963.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnesthesia Department, HospitalCooperative BehaviorFemaleFibrinolytic AgentsHumansInfusions, Intra-ArterialInterdisciplinary CommunicationMaleMiddle AgedPatient Care TeamPilot ProjectsProcess Assessment, Health CareProgram EvaluationPuncturesQuality ImprovementQuality Indicators, Health CareRetrospective StudiesStrokeThrombectomyThrombolytic TherapyTime and Motion StudiesTime FactorsTime-to-TreatmentTreatment OutcomeWorkflowConceptsPilot quality improvement projectQuality improvement projectPuncture timeMedian doorStroke patientsAnterior circulation stroke patientsIntra-arterial stroke therapyHospital time delayPre-QI cohortCompletion of imagingImprovement projectGreater delayNeurointerventional suiteHospital delayProximal occlusionIndependent predictorsStroke therapyPatient evaluationQI measuresWorse outcomesTherapy leadTreatment decisionsAnesthesia teamPatient arrivalPatients