Changing standard procedures for evaluating and treating patients with suspected stroke has led to improved access to lifesaving stroke surgery across the state of Delaware and should inform triage and treatment nationwide, according to research released today at the Society of NeuroInterventional Surgery's (SNIS) 21 st Annual Meeting. In "Direct From the Field Bypass to CSC Improves Timeliness and Likelihood of Thrombectomy for Patients with Emergent Large Vessel Occlusion," the members of the Delaware Stroke System worked with the state's emergency medical services (EMS) director to change the way that paramedics in Delaware evaluated individuals for suspected large vessel occlusion, increasing the number of patients who were immediately flown to comprehensive stroke centers for thrombectomy. These changes were implemented across the state in 2023.
During the first full year of implementation, 100 patients were flown directly to a comprehensive stroke center (CSC), hospitals with certified neurointerventional specialists on staff who can perform thrombectomies, bypassing the local primary stroke center (PSC). Of those patients confirmed to have a target vessel occlusion on imaging, 79 percent underwent thrombectomy. In prior years, that percentage was just 52% when patients arrived via inter-facility transfer.
These patients also received thrombectomy an estimated 2-3 hours earlier than if they had presented to the local PSC first. Strokes are often caused by a large vessel.