News | Stroke | August 16, 2019

Mobile Stroke Unit Gets Patients Quicker Treatment Than Traditional Ambulance

University of Texas Health Science Center study finds MSU-transported patients receive clot-busting procedures an average of 10 minutes faster

Mobile Stroke Unit Gets Patients Quicker Treatment Than Traditional Ambulance

Image courtesy of UTHealth McGovern Medical School

August 16, 2019 — Every second counts for stroke patients, as studies show they can lose up to 27 million brain cells per minute. Researchers at The University of Texas Health Science Center at Houston (UTHealth) recently published new findings in Stroke that show patients transported to the hospital by mobile stroke unit (MSU) instead of standard ambulance received a clot-busting procedure an average of 10 minutes faster, which could potentially save up to 270 million neurons per patient.1

In 2014, McGovern Medical School at UTHealth was the first in the nation to launch a mobile stroke unit, a specially equipped ambulance for diagnosing and treating stroke rapidly before hospital arrival.

Take a 360 view inside a mobile stroke unit ambulance

“The quicker we get stroke victims treatment that will restore blood flow, the more brain tissue we can save,” said Alexandra Czap, M.D., vascular neurology fellow in the Department of Neurology at McGovern Medical School and first author of the paper. “This study shows that mobile stroke units like ours can be effective in streamlining time to treatment, potentially saving neurological function and ultimately improving quality of life in stroke patients.”

The study looked at data from 161 patients from Houston and two other locations from 2014 to 2018 who underwent intra-arterial thrombectomy after suffering an acute ischemic stroke, the most common kind, which is caused by a blockage in a cerebral artery. The only medical therapy known to treat ischemic stroke, tissue plasminogen activator (tPA), is not always able to clear a large clot. To perform the procedure, also known as endovascular thrombectomy, a vascular neurologist threads a catheter usually through a groin artery up to the blockage, where a small device inserted into the catheter is used to remove the clot.

“This is a hallmark paper because it shows that pre-hospital evaluation and management on a mobile stroke unit can significantly reduce time to endovascular treatment for patients with large artery clots,” said Amanda L. Jagolino-Cole, M.D., a teleneurologist and assistant professor in the Department of Neurology at McGovern Medical School, who was the senior author of the paper.

While on board the unit, an interdisciplinary team can begin the process to assess whether the patient needs a thrombectomy, including diagnostic imaging, neurological exam and the administration of tPA. That gives the treatment team a head start and upon arrival to the hospital, the patient can be taken quickly to the endovascular suite for the procedure.

“Our mobile stroke unit allows us to bring the hospital to the patient,” Czap said. “We can complete the necessary diagnostic testing and notify the hospital that we are coming, so that the appropriate teams can be ready. Streamlining this process allowed for one of our recent mobile stroke unit patients to complete treatment in under two hours from onset of symptoms. Going forward, identification of possible thrombectomy candidates on the unit can increase the accuracy of triage and increase the number of patients having the procedure, which we hope will lead to better patient outcomes.”

The paper also shows an overall improvement in endovascular thrombectomy metrics for all patients regardless of how they arrived to the hospital. This is significant because the procedure just started to be recognized as standard management for select stroke patients within the last five years, Jagolino-Cole said.

This research is part of the ongoing BEST-MSU study, a prospective comparative effectiveness trial that investigates the benefits of stroke treatment delivered using a mobile stroke unit compared to standard management by emergency medical services. The primary outcomes are patients’ functional status at 90 days and long-term health care utilization. The BEST-MSU study will complete enrollment in 2020.

Watch the VIDEO: Creating and Operating a Mobile Stroke Unit

For more information: www.ahajournals.org/journal/str

 

Reference

1. Czap A.L., Grotta J.C., Parker S.A., et al. Emergency Department Door-to-Puncture Time Since 2014: Observations From the BEST-MSU Study. Stroke, published online June 11, 2019. https://doi.org/10.1161/STROKEAHA.119.025106

Related Content

Imaging Biometrics and Medical College of Wisconsin Awarded NIH Grant
News | Neuro Imaging | September 09, 2019
Imaging Biometrics LLC (IB), in collaboration with the Medical College of Wisconsin (MCW), has received a $2.75 million...
Neurological Brain Markers Might Detect Risk for Psychotic Disorders

Researchers at the University of Missouri used MRI scans similar to this photo to find neurological markers in the human brain. These markers can be used to detect people at risk for developing psychotic disorders and to understand when this risk has been successfully treated. Image courtesy of Marquette University/John Kerns.

News | Neuro Imaging | September 04, 2019
Help may be on the way for people who might lose contact with reality through a psychotic disorder, such as...
Delaware Imaging Network Now Offers NeuroQuant Brain Imaging MRI Software
News | Neuro Imaging | August 29, 2019
Delaware Imaging Network (DIN), Delaware’s largest network of outpatient medical imaging centers, has added NeuroQuant...
Smoldering Spots in the Brain May Signal Severe MS

NIH researchers found that dark rimmed spots representing ongoing, “smoldering” inflammation, may be a hallmark of more disabling forms of multiple sclerosis. Image courtesy of Reich lab, NIH/NINDS.

News | Neuro Imaging | August 22, 2019
Aided by a high-powered brain scanner and a 3-D printer, National Institutes of Health (NIH) researchers peered inside...
New MRI Technique Captures Brain Changes in Near-real Time

Differences in stiffness between stimulus states. Image courtesy of Patz et al.

News | Neuro Imaging | August 19, 2019
An international team of researchers developed a new magnetic resonance imaging (MRI) technique that can capture an...
ADHD Medication May Affect Brain Development in Children

Images of regions of interest (colored lines) in the white matter skeleton representation. Data from left and right anterior thalamic radiation (ATR) were averaged. Image courtesy of C. Bouziane et al.

News | Neuro Imaging | August 16, 2019
A drug used to treat attention-deficit/hyperactivity disorder (ADHD) appears to affect development of the brain’s...
Synaptive Medical Launches Modus Plan With Automated Tractography Segmentation
Technology | Neuro Imaging | August 07, 2019
Synaptive Medical announced the U.S. launch and availability of Modus Plan featuring BrightMatter AutoSeg. This release...
Statins Reduce Stroke, Cardiovascular Risk in Cancer Patients Following Radiation
News | Cardio-oncology | July 29, 2019
Cancer patients taking cholesterol-lowering statin medication following radiation therapy of the chest, neck or head...
Delta T1 Maps Provide Quantitative, Automated Solution to Assess Brain Tumor Burden
News | Neuro Imaging | July 05, 2019
Imaging Biometrics LLC (IB) a subsidiary of IQ-AI Ltd., is highlighting a recently published study in the American...
Third FDA Clearance Announced for Zebra-Med's AI Solution for Brain Bleed Alerts
Technology | Artificial Intelligence | June 19, 2019
Zebra Medical Vision announced it has received its third U.S. Food and Drug Administration (FDA) 510(k) clearance for...