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Updated: Jun 26, 2026
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
A quality improvement project on reimaging for provision of extended window mechanical thrombectomy when 24/7 service
Shadi M Ramadan1, Bernard Esisi1
1Hull University Teaching Hospitals NHS Trust, Hull, UK.
Background:
Mechanical thrombectomy (MT) has revolutionised the treatment of ischaemic stroke, leading to decreased rates of disability and mortality. However, many centres are unable to deliver a 24/7 service. Consequently, many patients who present in the non-operating hours are not considered for this treatment.
Methods:
We conducted a quality improvement project (QIP) to provide patients presenting out of hours with access to MT. To achieve this, we designed a protocol to rescan those patients just before opening of the service to select the candidates based on the favourable perfusion criteria.
Results:
Twenty-two out of the 39 patients included in the QIP had MT, which was not accessible before initiation of our protocol.
Conclusion:
In stroke centres where 24/7 MT service is not available, patients with large vessel occlusion (LVO) stroke, who present in the non-operating hours, can get access to this treatment by consideration of early morning rescanning just before opening of the service.
