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Original research
The burden of neurothrombectomy call: a multicenter prospective study
  1. Michelle M Williams1,
  2. Taylor A Wilson2,
  3. Thabele Leslie-Mazwi3,
  4. Joshua A Hirsch4,
  5. Ryan T Kellogg5,
  6. Alejandro M Spiotta5,
  7. Reade De Leacy6,
  8. J Mocco6,
  9. Felipe C Albuquerque7,
  10. Andrew F Ducruet7,
  11. Adam Arthur8,
  12. Visish M Srinivasan9,
  13. Peter Kan9,
  14. Maxim Mokin10,
  15. Travis M Dumont11,
  16. Alan Reeves12,
  17. Jasmeet Singh1,
  18. Stacey Q Wolfe1,
  19. Kyle M Fargen1
  1. 1 Department of Neurological Surgery, Wake Forest University, Winston Salem, North Carolina, USA
  2. 2 Department of Neurological Surgery, University of Arkansas, Little Rock, Arkansas, USA
  3. 3 Departments of Neurosurgery and Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4 Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  5. 5 Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  6. 6 Department of Neurosurgery, Mount Sinai Hospital, New York City, New York, USA
  7. 7 Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  8. 8 Department of Neurosurgery, University of Tennessee/Semmes-Murphy Clinic, Memphis, Tennessee, USA
  9. 9 Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
  10. 10 Department of Neurosurgery, University of South Florida, Tampa, Florida, USA
  11. 11 Department of Neurosurgery, University of Arizona, Tucson, Arizona, USA
  12. 12 Department of Radiology, Neuroendovascular Division, University of Kansas Medical Center, Kansas City, Kansas, USA
  1. Correspondence to Dr Michelle M Williams, Department of Neurological Surgery, Wake Forest University, Winston Salem, NC 27109, USA; williamsm0912{at}gmail.com

Abstract

Introduction Neurothrombectomy frequency is increasing, and a better understanding of the neurothrombectomy call burden is needed.

Methods Neurointerventional physicians at nine participating stroke centers prospectively recorded time requirements for all neurothrombectomy (NT) consultations over 30 consecutive 24 hour call periods.

Results Data were collected from a total of 270 days of call. 214 NT consultations were reported (mean 0.79 per day), including 130 ‘false positive’ consultations that ultimately did not lead to thrombectomy (mean 0.48 per day). 84 NT procedures were performed at the nine centers (0.32 per day, or 1 every 3 days). Most (59.8%) consultations occurred between 5pm and 7am. 30% of thrombectomy procedures resulted in delays in scheduled cases; treating physicians had to emergently travel to the hospital for 51.2% of these cases. A median of 27 min was spent on each false positive consultation and 171 min on each thrombectomy. Overall, the median physician time spent on NT responsibilities per 24 hour call period was 69 min (mean 85 min; IQR 16–135 min).

Conclusions NT consultations are frequent and often disrupt physician schedules, requiring physicians to commute in from home after hours in the majority of cases. As procedural and consultation volumes increase, it is crucial to understand the significant burden of call on neurointerventional physicians and develop strategies that reduce the potential for burnout. Importantly, this study was performed prior to the completion of the DAWN and DEFUSE3 trials; NT consultations are expected to continue to increase in the future.

  • thrombectomy
  • stroke
  • angiography
  • intervention
  • statistics

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Footnotes

  • Contributors Conception and design: KMF. Data collection and interpretation: all authors. Statistical analysis: TAW. Drafting the article: MMW, TAW, and KMF. Critical revision of the article: all authors. Final approval of the article: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Institutional review board approval wasobtained at the nine participating stroke centers.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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