[Mothership or drip and ship?]
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1Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Haus Ost 22 (O 22), Martinistr. 52, 20246, Hamburg, Deutschland. fiehler@uke.de.
Background:
The scientific evidence of the high efficacy of endovascular stroke treatment in large vessel occlusion (LVO) led to this treatment being accepted as the gold standard in these patients.
Objective:
This review article presents the various organizational models for thrombectomy and analyzes which model is preferred under which circumstances.
Material And Methods:
In an analysis of the recent scientific literature the models for optimizing patient transport (drip and ship or mothership) and optimizing the availability of interventionalists (drip and drive or remote mentoring) are presented and compared. In addition, considerations are made on thrombectomy rates and the prevalence of LVOs and the construction of organizational models.
Results:
If the location of the stroke patient is just as far from or closer to a comprehensive stroke center (CSC) than a primary stroke center (PSC), the patient should be transported directly to the CSC by mothership. If, on the other hand, a PSC is closer to the stroke site than a CSC and the time after the onset of symptoms lies within the lysis time window, this decision depends on many variables.
Conclusion:
Based on the unambiguous data situation, no recommendations can currently be made for a generally superior organizational model.
