Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| Technical University of Munich | OTHER |
| University of Regensburg | OTHER |
Not provided
Not provided
Not provided
Not provided
The aim of this study is to compare time delay and safety parameters of stroke patients initially admitted to a rural primary stroke center (PSC) who receive endovascular treatment (EVT) by a Flying Intervention Team with patients who receive EVT after secondary transfer to a comprehensive stroke center (CSC).
A novel health care concept was implemented in the telemedical stroke network TEMPiS (Telemedical Project for integrative Stroke Care) to reduce time delays to EVT in stroke patients with large vessel occlusion: After telemedicine-assisted identification of EVT candidates in a PSC, a Flying Intervention Team (neuroradiologist and angiography assistant) is flown from a CSC via helicopter to the PSC to perform EVT in the local angiography suite. Flying Intervention Team service runs from 8 a.m. to 10 p.m. Patients remain at local stroke unit for further treatment.
Analysis will include time delay to EVT, recanalization, symptomatic intracerebral hemorrhage, periprocedural complications, in-hospital complications, and mortality.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EVT by Flying Intervention Team in primary stroke center | Patients with ischemic stroke and large vessel occlusion admitted to a primary stroke center, for whom a Flying Intervention Team is flown to the primary stroke center in order to perform endovascular treatment. |
| |
| EVT after secondary transfer to comprehensive stroke center | Patients with ischemic stroke and large vessel occlusion admitted to a primary stroke center, who are transferred to a comprehensive stroke center for endovascular treatment. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endovascular treatment by Flying Intervention Team | Other | After telemedicine-assisted decision for endovascular treatment, the Flying Intervention Team is transferred via helicopter to the primary stroke center and performs endovascular treatment in the local angiography suite. |
| Measure | Description | Time Frame |
|---|---|---|
| Time from decision for endovascular treatment to groin puncture | Time from telemedicine-assisted decision for endovascular treatment to initiation of endovascular treatment by groin puncture | day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Time from symptom onset to recanalization | Time from symptom onset to recanalization of previously occluded target artery by endovascular treatment | day 1 |
| Other procedural times of hyperacute care |
Not provided
Inclusion criteria:
Inclusion criteria for primary study population:
Exclusion criteria for primary study population:
Not provided
Not provided
Not provided
Acute stroke patients eligible for endovascular treatment initially admitted to participating primary stroke center
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Gordian J Hubert, Dr. med. | München Klinik gGmbH | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| TEMPiS TeleStroke Network, Department of Neurology, Munich Municipal Hospital | Munich | Bavaria | 81545 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27673305 | Background | Saver JL, Goyal M, van der Lugt A, Menon BK, Majoie CB, Dippel DW, Campbell BC, Nogueira RG, Demchuk AM, Tomasello A, Cardona P, Devlin TG, Frei DF, du Mesnil de Rochemont R, Berkhemer OA, Jovin TG, Siddiqui AH, van Zwam WH, Davis SM, Castano C, Sapkota BL, Fransen PS, Molina C, van Oostenbrugge RJ, Chamorro A, Lingsma H, Silver FL, Donnan GA, Shuaib A, Brown S, Stouch B, Mitchell PJ, Davalos A, Roos YB, Hill MD; HERMES Collaborators. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016 Sep 27;316(12):1279-88. doi: 10.1001/jama.2016.13647. | |
| 31310296 |
| Label | URL |
|---|---|
| TEMPIS | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D020520 | Brain Infarction |
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002545 | Brain Ischemia |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
Not provided
Not provided
Not provided
Not provided
Not provided
|
Other procedural times between symptom onset, admission to PSC, first imaging, decision for endovascular treatment, initiation of endovascular treatment and completion of endovascular treatment
| day 1 |
| Recanalization | Proportion of patients with antegrade reperfusion of more than half of the previously occluded target artery ischemic territory after endovascular treatment | day 1 |
| Symptomatic intracerebral hemorrhage | Proportion of patients with symptomatic intracerebral hemorrhage | 7 days |
| In-hospital death or palliative care | In-hospital death or decision for palliative care | 7 days |
| Periprocedural complications | Proportion of patients with periprocedural, endovascular treatment associated complications | day 1 |
| In-hospital complications | Proportion of patients with other in-hospital complications | 7 days |
| Background |
| Jahan R, Saver JL, Schwamm LH, Fonarow GC, Liang L, Matsouaka RA, Xian Y, Holmes DN, Peterson ED, Yavagal D, Smith EE. Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. JAMA. 2019 Jul 16;322(3):252-263. doi: 10.1001/jama.2019.8286. |
| 38238050 | Derived | Leitner MA, Hubert GJ, Paternoster L, Leitner MI, Remi JM, Trumm C, Haberl RL, Hubert ND. Clinical outcome of rural in-hospital-stroke patients after interhospital transfer for endovascular therapy within a telemedical stroke network in Germany: a registry-based observational study. BMJ Open. 2024 Jan 18;14(1):e071975. doi: 10.1136/bmjopen-2023-071975. |
| 33849042 | Derived | Hubert GJ, Kraus F, Maegerlein C, Platen S, Friedrich B, Kain HU, Witton-Davies T, Hubert ND, Zimmer C, Bath PM, Audebert HJ, Haberl RL. The "Flying Intervention Team": A Novel Stroke Care Concept for Rural Areas. Cerebrovasc Dis. 2021;50(4):375-382. doi: 10.1159/000514845. Epub 2021 Apr 13. |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |