Acute Stroke Clinical Trial
Official title:
Reducing Disparities in Mechanical Embolectomy Access for Patients of New York City Via a Mobile Interventional Stroke Team: Systems of Care and Time-To-Treatment
Endovascular treatment has recently become the recommended therapy for acute stroke after the
publication of five randomized trials (MR CLEAN1, ESCAPE2, EXTEND IA3, SWIFT PRIME4,
REVASCAT5) in 2015 that demonstrate its efficacy. Hospitals need to adapt to these updated
stroke care guidelines, and many hospitals are not appropriately equipped for
neurointerventional procedures. Decreased time to treatment is associated with favorable
clinical outcomes, and best practices to optimize workflow between comprehensive stroke
centers and secondary hospitals have become an important area of study. This prospective
study is being conducted on acute stroke cases within the Mount Sinai Health System from 1
June 2016 up until 31 December 2018. The researchers would like to evaluate how variable
methods of interventional service delivery for acute stroke affect clinical measures and
outcomes.
More specifically, the researchers are conducting this study in order to determine whether
outcomes of neurointervention for large vessel occlusion in stroke, for patients presenting
to and receiving treatment at a comprehensive stroke center, will be superior to that
delivered by a mobilized intervention team at a central satellite hospital. In particular,
the hypothesis is that factors affecting outcome include presentation to secondary hospital,
delays with transfer including traffic conditions and time of day, and the acquisition of
complex imaging within secondary hospitals.
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