IAT-TiMES

Intra-arterial Transfer Time Metric Study

Sean Savitz, M.D.

Co-PI

Impact

A stroke is when a blood vessel in the brain is blocked by a blood clot which leads to brain dysfunction. In a subset of stroke patients that have large blood clots as the cause of their stroke, they can be treated with a catheter-based therapy which can be deployed to potentially extract the clot and restore blood flow to the brain before permanent brain injury ensues. This procedure, called intra-arterial thrombectomy (IAT), is often only performed at large stroke centers and not available at outlying, smaller community hospitals. This study aims to analyze the transfer process of these patients from smaller hospitals to larger stroke centers to identify barriers in the transfer process.

The transfer process is complex and often involves multiple teams of physicians and administrative personnel to coordinate the transfer of the patient. The complexity can often lead to delays in the arrival of the patient to the larger stroke center and possibly lead to less than ideal outcomes or at times often exclude the patient from the procedure due to the limited time window. Currently, there are no standard time metrics recommended for the process of intra-arterial thrombectomy transfers.

This study will help establish protocols to optimize processes that will accelerate the transfer of these patients in order to receive treatment faster. We, therefore, aim to describe the current landscape of IAT transfer times at Texas CSCs/IAT-capable stroke centers to identify barriers/delays in the transfer process (phase 1). We then seek to develop best practices to optimize the transfer of patients destined for IAT (phase 2). Participation completed at Lone Star Stroke hubs UTHSC Houston, Seton, UTHSC San Antonio, UT Southwestern, TTUHSC Lubbock hub and spokes participation coming FY19 at TTUHSC El Paso and Valley Baptist. 70 patients are currently enrolled with a target enrollment of 100.

Abstracts

IAT-Times: Intra-arterial Transfer Time Metrics Study—Southern California Kaiser Permanente and University of Texas Houston Telestroke Network Experience. Tzu-Ching Wu1, Navdeep Sangha2, Feryal Elorr1, Edgar Olivas2, Christy Ankrom1, Arvind Bambhroliya1, Shima Bozorgui1, Amanda Jagolino1, Tiffany Cossey1, Sean Savitz1
1Department of Neurology, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth): Houston, TX 2Department of Neurology, Southern California Kaiser Permanente: Los Angeles, CA
Moderated poster presented at the 2017 International Stroke Conference, Houston, Texas.

A stroke is when a blood vessel in the brain is blocked by a blood clot which leads to brain dysfunction. In a subset of stroke patients that have large blood clots as the cause of their stroke, they can be treated with a catheter-based therapy which can be deployed to potentially extract the clot and restore blood flow to the brain before permanent brain injury ensues. This procedure, called intra-arterial thrombectomy (IAT), is often only performed at large stroke centers and not available at outlying, smaller community hospitals. This study aims to analyze the transfer process of these patients from smaller hospitals to larger stroke centers to identify barriers in the transfer process. The transfer process is complex and often involves multiple teams of physicians and administrative personnel to coordinate the transfer of the patient. The complexity can often lead to delays in the arrival of the patient to the larger stroke center and possibly lead to less than ideal outcomes or at times often exclude the patient from the procedure due to the limited time window. Currently, there are no standard time metrics recommended for the process of intra-arterial thrombectomy transfers. This study will help establish protocols to optimize processes that will accelerate the transfer of these patients in order to receive treatment faster. We, therefore, aim to describe the current landscape of IAT transfer times at Texas CSCs/IAT-capable stroke centers to identify barriers/delays in the transfer process (phase 1). We then seek to develop best practices to optimize the transfer of patients destined for IAT (phase 2). Participation completed at Lone Star Stroke hubs UTHSC Houston, Seton, UTHSC San Antonio, UT Southwestern, TTUHSC Lubbock hub and spokes participation coming FY19 at TTUHSC El Paso and Valley Baptist. 70 patients are currently enrolled with a target enrollment of 100.IAT-Times: Intra-arterial Transfer Time Metrics Study—Southern California Kaiser Permanente and University of Texas Houston Telestroke Network Experience. Tzu-Ching Wu1, Navdeep Sangha2, Feryal Elorr1, Edgar Olivas2, Christy Ankrom1, Arvind Bambhroliya1, Shima Bozorgui1, Amanda Jagolino1, Tiffany Cossey1, Sean Savitz1 1Department of Neurology, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth): Houston, TX 2Department of Neurology, Southern California Kaiser Permanente: Los Angeles, CA Moderated poster presented at the 2017 International Stroke Conference, Houston, Texas.