A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes. The study was presented at the Society of NeuroInterventional Surgery’s (SNIS) 15th Annual Meeting.
Door to Revascularization in Less than 60 Minutes: A Cost and Benefit Analysis mentions that while standardized protocols for imaging and transport to the angiography suite, as well as a standardization of the thrombectomy procedure, help save time, the most important time savings comes from having a neurointerventional team meet the patient when they arrive in the emergency room. The five-person team includes one registered nurse (RN), two technologists, one anesthesiologist, and one neurointerventionalist.
“Level 1 trauma centers require trauma surgeons and anesthesiologists to be in-house 24/7. By requiring Level 1 stroke centers to do the same, we could potentially help more ELVO patients make full recoveries,” said Dr. Donald Frei, lead author of the study and a neurointerventionalist based in Colorado.
Rapid endovascular thrombectomy helps patients with ELVO achieve the best outcomes, but standardizing stroke protocols to ensure timely and safe care does come at a cost. The study considered 1,162 ELVO alerts met by the neurointerventional team. Of these, 314 patients (27 percent) received a thrombectomy. In cases in which a thrombectomy was not performed, the RN and technologists are paid two hours each of overtime pay, averaging to a total cost of more than $200,000 in overtime pay annually for the salaried staff. This does not include physician time spent.
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