Improvement of Endovascular Stroke Treatment: A 24-Hour Neuroradiological On-Site Service Is Not Enough.

Background And Purpose: With the advent of endovascular stroke treatment (EST) with mechanical thrombectomy, stroke treatment has also become more challenging. Purpose of this study was to investigate whether a fulltime neuroradiological on-site service and workflow optimization with a structured documentation of the interdisciplinary stroke workflow resulted in improved procedural times.

Material And Methods: Procedural times of 322 consecutive patients, who received EST (1) before ( = 96) and (2) after ( = 126) establishing a 24-hour neuroradiological on-site service as well as (3) after implementation of a structured interdisciplinary workflow documentation ("Stroke Check") ( = 100), were analysed.

Results: A fulltime neuroradiological on-site service resulted in a nonsignificant improvement of procedural times during out-of-hours admissions ( ≥ 0.204). Working hours and out-of-hours procedural times improved significantly, if additional workflow optimization was realized ( ≤ 0.026).

Conclusions: A 24-hour interventional on-site service is a major prerequisite to adequately provide modern reperfusion therapies in patients with acute ischemic stroke. However, simple measures like standardized and focused documentation that affect the entire interdisciplinary pre- and intrahospital stroke rescue chain seem to be important.