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KMID : 0191120180330190143
Journal of Korean Medical Science
2018 Volume.33 No. 19 p.143 ~ p.143
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

Kim Byung-Jun
Jung Cheol-Kyu
Nam Hyo-Suk
Lee Jin-Soo
Kim Jin-Woo
Lee Woong-Jae
Seo Woo-Keun
Heo Ji-Hoe
Baik Seung-Kug
Kim Byung-Moon
Rha Joung-Ho
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 team for EVT candidate prior to imaging, neurointervention 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.
KEYWORD
Endovascular Treatment, Door-To-Reperfusion Time, Hyperacute Stroke, Pre-hospital Notification
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