Cardiology Division, Baptist Medical Center Princeton, Birmingham, Alabama.
Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
Catheter Cardiovasc Interv. 2021 Apr 1;97(5):874-875. doi: 10.1002/ccd.29315. Epub 2020 Oct 22.
Team-based care has been emphasized as a strategy to improve and optimize outcomes for broad groups of patients who have presented with often complex medical conditions including large vessel cerebral occlusion. Although neurointerventionalists from different specialties perform mechanical embolectomy, which has become the standard of care for large vessel cerebral occlusion, these specialties are limited by relatively low numbers typically concentrated in a small number of sites. In this single center experience, approximately 50 patients with large vessel stroke were transferred out of an emergency room to other centers despite the availability of an experienced cardiologist with extensive carotid experience. Such transfer strategies typically result in delays in receiving reperfusion and, therefore, may decrease the success rates and substantial improvement that can be obtained by patients in this setting. Trained interventional cardiologists in centers with limited 24/7/365 coverage could achieve rapid revascularization and reperfusion saving lives. In order to accommodate the need for treating these patients, carotid stent trained cardiologists should enter the arena, learn mechanical embolectomy, and be supported by their colleagues from other disciplines on acute stroke care teams.
团队式护理已被强调为一种策略，旨在改善和优化经常出现复杂医疗状况的广大患者的治疗效果，其中包括大血管闭塞。尽管来自不同专业的神经介入医生已经开展机械取栓治疗，这已成为大血管闭塞的治疗标准，但这些专业医生数量相对较少，通常集中在少数几个地点。在这个单中心的经验中，尽管有一位经验丰富的、广泛涉猎颈动脉疾病的心脏病专家，但仍有约 50 名大血管卒中患者从急诊室转往其他中心。这种转院策略通常会导致再灌注治疗的延迟，因此可能会降低该环境下患者获得的成功率和实质性改善。在覆盖范围有限的 24/7/365 的中心，接受过培训的介入心脏病学家可以实现快速血管再通和再灌注，从而拯救生命。为了满足治疗这些患者的需求，颈动脉支架置入术培训过的心脏病学家应该加入该领域，学习机械取栓术，并得到来自急性卒中护理团队的其他学科同事的支持。
