Abstract TP249: Drip, Drive, and Retrieve - New Application of Mobile Neuro IVR Team -

Abstract

[Background and Purpose] Neuro-interventional radiology (NIVR) is increasingly recognized as an essential option for acute stroke treatment. However, the access to NIVR physician or NIVR-capable hospital is still limited. Patient transfer system between primary stroke centers (PSCs) and comprehensive stroke centers has a problem about deterioration during transfer, insufficient information transmission, small area coverage, and loss of time. We organized a mobile NIVR team consisting of 6-7 board certified NIVR physicians, and concluded a NIVR alliance program with affiliating PSCs. The team performed procedures at the local sites on request of PSCs. [Methods] Between 2008 and 2012, we concluded a NIVR alliance program with 7 affiliated PSCs. The team dispatched NIVR physicians to the PSCs immediately after receiving "rescue call." Clinical information including medical images was updated in real-time and interactive manner during travel. [Results] We received 23 calls and reacted to all cases. We treated 8 cases of acute ischemic stroke (6 mechanical thrombectomy, 3 carotid stenting, 5 for non-responder to intravenous rt-PA), and 15 for subarachnoid hemorrhage (14 aneurysm embolization, one parent artery occlusion). The mean travel distance was 39.0 km (min - max: 6.3 - 90.3). For acute ischemic stroke, the mean "door-to-puncture time" was 154 minutes (min - max: 130 - 168). For subarachnoid hemorrhage, procedure was performed on the onset or the next day. All the procedure were successfully performed and no deterioration related to procedure were observed. [Conclusions] The new application of NIVR delivery system can safely enable to avoid deterioration during transfer, cover larger area without delay, and enlarge the opportunity to access NIVR therapy for acute stroke patients.

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