Helicopters promoted for stroke response

A research article published online by the Journal of NeuroInterventional Surgery this May has outlined how helicopters could improve outcomes for stroke patients by transporting specialised physicians to them. Titled Helistroke: neurointerventionalist helicopter transport for interventional stroke treatment: proof of concept and rationale, the article was authored by a team from Maryland, US, including Dr Ferdinand K Hui from the Department of Radiology at Johns Hopkins Hospital.

The authors present a proof-of-concept case where a neurointerventionalist was flown by helicopter from one hospital to another facility in the same network with an on-site angiographic suite, in order to speed up the treatment of a stroke victim. Explaining the rationale, they said: “It is increasingly recognised that time is one of the key determinants in acute stroke outcome when interventional stroke therapy is applied. With increasing device efficacy and understanding of imaging triage options, reducing pre-treatment time loss may be a critical component of improving interventional stroke outcomes for the population at large. Time-sensitive procedures such as organ harvest have transported physicians to the patient site to improve time to procedure. Applying this same principle to interventional stroke management may be a valid paradigm.”

In advance of the case examined, the team consulted with the hospital involved and local air ambulance providers and secured funding. When an appropriate patient with large vessel occlusion and an NIH Stroke Scale score above eight was identified, an MRI was performed and the air transport of the physician was requested.

The proof-of-concept case was identified and medevac was consulted at 12:13 hrs, said the researchers, after verifying that no in-house emergencies would prevent physician departure. The authors continued: “Weather clearance was obtained and stroke intervention confirmed as a go at 12:24. Groin puncture occurred at 13:07 and the intervention was completed at 13:41. The total time from decision-to-treat to groin puncture was 43 min and groin closure was completed at 77 min from decision-to-treat.”

Based on the example case, the researchers stated their belief that the model may be another option in the spoke-and-hub design of stroke systems of care.

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