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P-005 The rising rate of neurothrombectomy procedures
  1. M Williams1,
  2. S Wolfe1,
  3. J Singh1,
  4. A Reeves2,
  5. T Dumont3,
  6. A Spiotta4,
  7. R De Leacy5,
  8. J Mocco5,
  9. N Goyal6,
  10. A Arthur7,
  11. M Mokin8,
  12. A Ducruet9,
  13. F Albuquerque9,
  14. P Kan10,
  15. T Leslie-Mazwi11,
  16. J Hirsch11,
  17. K Fargen1
  1. 1Neurosurgery, Wake Forest Baptist Medical Center, Winston Salem, NC
  2. 2Neuroendovascular Division, Department of Radiology, University of Kansas Medical Center, Kansas City, KS
  3. 3Neurosurgery, University of Arizona Medical Center, Tucson, AZ
  4. 4Neurosurgery, Medical Univeristy of South Carolina, Charleston, SC
  5. 5Neurosurgery, Mount Sinai Hospital, New York, NY
  6. 6Neurointervention, University of Tennessee/Semmes-Murphy Clinic, Memphis, TN
  7. 7Neurosurgery, University of Tennessee/Semmes-Murphy Clinic, Memphis, TN
  8. 8Neurosurgery, University of South Florida, Tampa, FL
  9. 9Neurosurgery, Barrow Neurological Institute, Phoenix, AZ
  10. 10Neurosurgery, Baylor College of Medicine, Houston, TX
  11. 11Interventional Neuroradiology, Massachusetts General Hospital, Boston, MA


Introduction A prospective study in 2017 at 10 high-volume stroke centers demonstrated an incidence of neurothrombectomy (NT) procedures approximating once every 3 days with a mean daily stroke burden of 85 minutes. With the expansion of the interventional time window for large vessel occlusion following DAWN and DEFUSE 3, the rate of NT consults and procedures are on the rise.

Methods Neurointerventional physicians at 10 participating stroke centers prospectively recorded time requirements for all NT consultations over 30 consecutive 24-hour call periods, including both false positive consultations and NT procedures. Data was collected between May-October 2018, depending on the center.

Results Data was collected from a total of 300 days of call. A total of 294 NT consultations were reported (mean 0.98 per day), including 128 false positive consultations. A total of 166 procedures were performed across the 10 centers (mean 0.55 per day). Six of the 9 centers that also participated in the 2017 study had higher procedural rates per day in 2018 compared to 2017. Fifty-six percent of all consultations and 48% of procedures occurred during non-peak work hours, respectively. Additionally, the ratio of procedures performed to false consultations increased from 0.65 in 2017 to 1.3 in 2018. The average daily NT time requirement per 24 hour call was 124 minutes.

Conclusions NT procedural rates at the same centers have increased from 1 every 5 days in 2016, to 1 in 3 in 2017, to now 1 every 2 days in 2018. The average NT call burden has increased to over 2 hours per 24 hour call shift. This study demonstrates that NT procedural and consultation volumes have increased even further following publication of DAWN and DEFUSE.

Disclosures M. Williams: None. S. Wolfe: None. J. Singh: None. A. Reeves: None. T. Dumont: None. A. Spiotta: None. R. De Leacy: None. J. Mocco: None. N. Goyal: None. A. Arthur: None. M. Mokin: None. A. Ducruet: None. F. Albuquerque: None. P. Kan: None. T. Leslie-Mazwi: None. J. Hirsch: None. K. Fargen: None.

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