Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Consensus Statements by Korean Society of Interventional Neuroradiology and Korean Stroke Society: Hyperacute Endovascular Treatment Workflow to Reduce Door-to-Reperfusion Time

  • Kim, Dae-Hyun (Department of Neurology, Dong-A University Hospital) ;
  • Kim, Byungjun (Department of Radiology, Korea University Anam Hospital) ;
  • Jung, Cheolkyu (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Nam, Hyo Suk (Department of Neurology, Yonsei University Severance Hospital) ;
  • Lee, Jin Soo (Department of Neurology, Ajou University School of Medicine) ;
  • Kim, Jin Woo (Department of Radiology, Inje Univeristy Ilsan Paik Hospital) ;
  • Lee, Woong Jae (Department of Radiology, Chung-Ang University Hospital) ;
  • Seo, Woo-Keun (Department of Neurology, Sungkyunkwan University, Samsung Medical Center) ;
  • Heo, Ji-Hoe (Department of Neurology, Yonsei University Severance Hospital) ;
  • Baik, Seung Kug (Department of Radiology, Pusan National University Yangsan Hospital) ;
  • Kim, Byung Moon (Department of Radiology, Yonsei University Severance Hospital) ;
  • Rha, Joung-Ho (Department of Neurology, Inha University Hospital)
  • Received : 2018.06.06
  • Accepted : 2018.06.06
  • Published : 2018.10.01
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Abstract

Recent clinical trials demonstrated the clinical benefit of endovascular treatment (EVT) in patients with acute ischemic stroke due to large vessel occlusion. These trials confirmed that good outcome after EVT depends on the time interval from symptom onset to reperfusion and that in-hospital delay leads to poor clinical outcome. However, there has been no universally accepted in-hospital workflow and performance benchmark for rapid reperfusion. Additionally, wide variety in workflow for EVT is present between each stroke centers. In this consensus statement, Korean Society of Interventional Neuroradiology and Korean Stroke Society Joint Task Force Team propose a standard workflow to reduce door-to-reperfusion time for stroke patients eligible for EVT. This includes early stroke identification and pre-hospital notification to stroke team of receiving hospital in pre-hospital phase, the transfer of stroke patients from door of the emergency department to computed tomography (CT) room, warming call to neurointervention (NI) team for EVT candidate prior to imaging, NI team preparation in parallel with thrombolysis, direct transportation from CT room to angiography suite following immediate decision of EVT and standardized procedure for rapid reperfusion. Implementation of optimized workflow will improve stroke time process metrics and clinical outcome of the patient treated with EVT.

Keywords

References

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