Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Institute of Neuroradiology, University Medical Center Goettingen, Goettingen, Germany; Department of Neuroradiology, University Hospital Basel, Basel, Switzerland.
Handb Clin Neurol. 2021;176:409-415. doi: 10.1016/B978-0-444-64034-5.00022-5.
In order to reduce intrahospital times for stroke patients, we have implemented various strategies throughout the last 4 years. Swift restoration of cerebral perfusion is essential for the outcomes of patients with acute ischemic stroke. Endovascular treatment (EVT) has become the standard of care to accomplish this in patients with acute stroke due to large vessel occlusion (LVO). To achieve reperfusion of ischemic brain regions as fast as possible, all in-hospital time delays have to be avoided. Therefore management of patients with acute ischemic stroke was optimized with an interdisciplinary standard operating procedure (SOP). Stroke neurologists, diagnostic as well as interventional neuroradiologists, and anesthesiologists streamlined all necessary processes from patient admission and diagnosis to EVT of eligible patients. In a second step we established a one-stop management of stroke patients, meaning that imaging was acquired with the same angiography suite use for treatment of patients with LVO. In the last section of this chapter we discuss the latest trials on stroke therapy and their implications for our current triage systems and imaging patterns.
为了减少脑卒中患者的住院时间，我们在过去 4 年中实施了各种策略。快速恢复脑灌注对于急性缺血性脑卒中患者的预后至关重要。血管内治疗（EVT）已成为治疗急性脑卒中伴大血管闭塞（LVO）患者的标准治疗方法。为了尽快实现缺血性脑区的再灌注，必须避免所有院内时间延迟。因此，我们通过跨学科标准操作流程（SOP）优化了急性缺血性脑卒中患者的管理。脑卒中神经科医生、诊断和介入神经放射科医生以及麻醉师简化了从患者入院和诊断到符合条件的患者进行 EVT 的所有必要流程。在第二步中，我们建立了脑卒中患者的一站式管理，即使用相同的血管造影套件进行 LVO 患者的治疗和成像。在本章的最后一节中，我们讨论了最新的脑卒中治疗试验及其对我们当前分诊系统和成像模式的影响。
