Fast-track intubation for accelerated interventional stroke treatment.

Area of Science:

• Neurology
• Interventional Neuroradiology
• Emergency Medicine

Background:

• Intravenous thrombolysis often fails for proximal intracranial artery occlusions.
• Interventional recanalization therapy is a key treatment for acute ischemic stroke.
• Optimal periprocedural management for these interventions requires further investigation.

Purpose of the Study:

• Identify factors contributing to delays in door-to-treatment times for stroke interventions.
• Evaluate the impact of a fast-track intubation standard operating procedure (I-SOP) on door-to-angiography time.

Main Methods:

• Retrospective analysis of 48 acute stroke patients undergoing interventional recanalization (2006-2009).
• Prospective analysis of 23 consecutive patients after implementing an I-SOP for fast-track intubation.
• Door-to-angiography time was the primary endpoint, defined from hospital admission to procedure start.

Main Results:

• Retrospective analysis showed a mean door-to-angiography time of 2.2 hours.
• Patients intubated prior to admission had significantly shorter door-to-angiography times (51 min reduction).
• I-SOP implementation reduced mean door-to-angiography time by 25 minutes in prospective analysis.

Conclusions:

• Pre-procedural intubation in acute stroke patients can delay interventional treatment initiation.
• Implementing an I-SOP effectively accelerates interventional treatment initiation for stroke patients.