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Krug N, Braun H, Knez A, Auerbach H, Bodenberger S, Eglseder B, Kirschke J, Boeckh-Behrens T, Wunderlich S, Henninger J, Boy S, Renz M, Sepp D, Zimmer C, Maegerlein C. Interdisciplinary Rendez-Vous Approach in Endovascular Stroke Treatment: A New Concept to Accelerate Mechanical Thrombectomy in Primary Stroke Centers. Cardiovasc Intervent Radiol 2024; 47:109-114. [PMID: 37989788 PMCID: PMC10769944 DOI: 10.1007/s00270-023-03610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE Prompt endovascular treatment of patients with stroke due to intracranial Large Vessel Occlusion (LVO) is a major challenge in rural areas because neurointerventionalists are usually not available. As a result, treatment is delayed, and clinical outcomes are worse compared with patients primarily treated in comprehensive stroke centers (CSC). To address this problem, we present a concept in which interdisciplinary, on-site endovascular treatment is performed in a Primary Stroke Center (PSC) by a team of interventional neuroradiologists and cardiologists: the Rendez-Vous approach. METHODS Thirty-five patients with LVO who underwent interdisciplinary thrombectomy on-site at the PSC as part of the Rendez-Vous concept were compared with 72 patients who were transferred from a PSCs to the CSC for thrombectomy when diagnosed with LVO in terms of temporal sequences and clinical outcomes. RESULTS Patients treated on-site at the PSC as part of the Rendez-Vous approach were managed as successfully and without an increase in complication rates compared with patients treated secondarily at a CSC (91.7% successful interventions in Rendez-Vous vs. 87.3% in control group, p = 0.57). The time from diagnosis of LVO to groin puncture was reduced by mean 74.3 min with the Rendez-Vous concept (p < 0.01). Regarding the clinical outcome, a functionally independent status was achieved in 45.5% in the Rendez-Vous group and in 22.6% in the control group (p = 0.029). CONCLUSION Thanks to interdisciplinary teamwork between cardiology and interventional neuroradiology in local PSCs, times to successful reperfusion can be reduced. This has a potentially positive impact on the clinical outcome of stroke patients.
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Affiliation(s)
- Nadja Krug
- Diagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Holger Braun
- Medical Department, Krankenhaus Weilheim, Weilheim, Germany
| | - Andreas Knez
- Medical Department, Krankenhaus Weilheim, Weilheim, Germany
| | | | | | | | - Jan Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Tobias Boeckh-Behrens
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Silke Wunderlich
- Department of Neurology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | | | - Sandra Boy
- Department of Neurology, Asklepios Stadtklinik Bad Tölz, Bad Tölz, Germany
| | - Martin Renz
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Dominik Sepp
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Christian Maegerlein
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.
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