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Wide Variability in Prethrombectomy Workflow Practices in the United States: A Multicenter Survey.

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Workflow for mechanical thrombectomy in acute ischemic stroke varies widely across experienced centers. Understanding these real-world practices can help hospitals optimize their own stroke treatment protocols.

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Health Systems Research

Background:

  • Mechanical thrombectomy is crucial for acute ischemic stroke outcomes.
  • Standardized prethrombectomy workflows are lacking.
  • Awareness of existing workflows at experienced centers can guide developing hospitals.

Purpose of the Study:

  • To survey and analyze prethrombectomy workflow practices at experienced stroke centers in the US.
  • To identify variations and commonalities in workflow components.
  • To provide insights for optimizing stroke care protocols.

Main Methods:

  • Conducted email and phone interviews with neurointerventional team members.
  • Surveyed 30 experienced, endovascular-capable stroke centers.
  • Focused on workflow components: triage, team activation, transport, setup, and anesthesia.

Main Results:

  • Significant variation exists in prethrombectomy workflows.
  • Practices differ in staff response to alerts, imaging triage, and team activation timing.
  • Variations observed in patient transport, procedural setup, and use of equipment like power injectors.

Conclusions:

  • Prethrombectomy workflows demonstrate wide variability among experienced centers.
  • Increased awareness of these diverse workflows can inform protocol development.
  • This knowledge can assist institutions in designing effective patient care pathways.