ArticlePloS one2016
Effects of Workflow Optimization in Endovascularly Treated Stroke Patients - A Pre-Post Effectiveness Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Recommendations for Mechanical Thrombectomy in Patients with Acute Ischemic Stroke : A Clinical Guide by the Hellenic Stroke Organization.Clinical neuroradiology · 2018Guideline
- One-Stop Management Improves Outcome for Large Vessel Occlusion Stroke.Stroke (Hoboken, N.J.) · 2026Article
- Size and location of intracranial hemorrhage in acute stroke presentations: correlation with baseline NIHSS and relevance to direct-to-angiography workflows.Frontiers in neurology · 2026Article
- Hybrid CT Angio Suite for Acute Ischemic Stroke: A New Time-Saving Workflow Model?Journal of clinical medicine · 2025Article
- Effect of Workflow Improvements on Time to Endovascular Thrombectomy for Acute Ischemic Stroke in the MR CLEAN Registry.Stroke (Hoboken, N.J.) · 2023Article
- Access to and application of recanalizing therapies for severe acute ischemic stroke caused by large vessel occlusion.Neurological research and practice · 2023Article
- Evaluation of direct-to-angiography suite (DTAS) and conventional clinical pathways in stroke care: a simulation study.Journal of neurointerventional surgery · 2022Observational
- The effectiveness of systemic and endovascular intra-arterial thrombectomy protocol for decreasing door-to-recanalization time duration.Journal of cerebrovascular and endovascular neurosurgery · 2022Article
- Article
- Impacts of in-hospital workflow on functional outcome in stroke patients treated with endovascular thrombectomy.Journal of thrombosis and thrombolysis · 2021Article
- Reducing door-to-reperfusion time in acute stroke endovascular therapy using magnetic resonance imaging as a screening modality.Journal of neurointerventional surgery · 2020Article
- Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study.BMJ open · 2020Article
- One-Stop Management of 230 Consecutive Acute Stroke Patients: Report of Procedural Times and Clinical Outcome.Journal of clinical medicine · 2019Article
- STEPS-T Program Improves Endovascular Treatment Outcomes of Acute Ischemic Stroke; A 6-Year Study.Frontiers in neurology · 2019Article
- Consensus Statements by Korean Society of Interventional Neuroradiology and Korean Stroke Society: Hyperacute Endovascular Treatment Workflow to Reduce Door-to-Reperfusion Time.Journal of Korean medical science · 2018Article
- Endovascular treatment outcomes using the Stroke Triage Education, Procedure Standardization, and Technology (STEPS-T) program.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2018Article
- Optimized Management of Endovascular Treatment for Acute Ischemic Stroke.Journal of visualized experiments : JoVE · 2018Article
- Improvement of Endovascular Stroke Treatment: A 24-Hour Neuroradiological On-Site Service Is Not Enough.BioMed research international · 2018Article
- Early computed tomography-based scores to predict decompressive hemicraniectomy after endovascular therapy in acute ischemic stroke.PloS one · 2017Article
- Consensus Statements by Korean Society of Interventional Neuroradiology and Korean Stroke Society: Hyperacute Endovascular Treatment Workflow to Reduce Door-to-Reperfusion Time.Korean journal of radiologyReview
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Endovascular treatment of acute ischemic stroke has become standard of care for patients with large artery occlusion. Early restoration of blood flow is crucial for a good clinical outcome. We introduced an interdisciplinary standard operating procedure (SOP) between neuroradiologists, neurologists and anesthesiologists in order to streamline patient management. This study analyzes the effect of optimized workflow on periprocedural timings and its potential influence on clinical outcome. Data were extracted from a prospectively maintained university hospital stroke database. The standard operating procedure was established in February 2014. Of the 368 acute stroke patients undergoing endovascular treatment between 2008 and 2015, 278 patients were treated prior to and 90 after process optimization. Outcome measures were periprocedural time intervals and residual functional impairment. After implementation of the SOP, time from symptom onset to reperfusion was significantly reduced (median 264 min prior and 211 min after SOP-introduction (IQR 228-32 min and 161-278 min, respectively); P<0.001). Especially faster supply of imaging and prompt transfer of patients to the angiography suite contributed to this effect. Time between hospital admission and groin puncture was reduced by half after process optimization (median 64 min after versus 121 min prior to SOP-introduction (IQR 54-77 min and 96-161 min, respectively); P<0.001). Clinical outcome was significantly better after workflow optimization as measured with the modified Rankin Scale (common odds ratio (OR) 0.56; 95% CI 0.32-0.98; P = 0.038). Optimization of workflow and interdisciplinary teamwork significantly improved the outcome of patients with acute ischemic stroke due to a significant reduction of in-hospital examination, transportation, imaging and treatment times.
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