Ischemic stroke patients who received mechanical clot removal by a mobile interventional stroke team (MIST) had better 90-day outcomes than patients who were first transported to a hospital for the procedure. The study, performed by stroke specialists at Mount Sinai Health System in New York City, evaluated their MIST model of bringing a surgical procedure, endovascular thrombectomy, to patients in the field.

“Endovascular thrombectomy for large vessel occlusion stroke is a time-sensitive intervention. The use of a Mobile Interventional Stroke Team (MIST) traveling to Thrombectomy Capable Stroke Centers to perform endovascular thrombectomy has been shown to be significantly faster with improved discharge outcomes, as compared with the drip-and-ship (DS) model,” wrote lead author Jacob Morely and his team. 

Key Findings—

According to a report released August 5, 2021, by the American Heart Association, the key findings were

• For patients treated within six hours of stroke onset, the early window, the rate for a good outcome (mRS less than or equal to 2 – mobile and can perform daily tasks) three months after the event was significantly higher in patients from the MIST group (54%), compared to the patients in the transferred group (28%).
• Among patients treated during the early window, functional outcomes at discharge were significantly better among the MIST patients than the transferred patients.
• For patients treated in the late window, however, outcomes were similar: 35% of patients in the MIST group had a good 90-day outcome, compared to 41% in the transferred group.

“Ischemic strokes often progress rapidly and can cause severe damage because brain tissue dies quickly without oxygen, resulting in serious long-term disabilities or death. Assessing and treating stroke patients in the early window means that a greater number of fast-progressing strokes are identified and treated,” noted study co-author Johanna T. Fifi, M.D., associate professor of neurosurgery, neurology, and radiology in the department of neurosurgery at the Icahn School of Medicine at Mount Sinai in New York City.

Sources:

Jacob R. Morey, Xiangnan Zhang, Naoum Fares Marayati, Stavros Matsoukas, Emily Fiano, Thomas Oxley, Neha Dangayach, Laura K. Stein, Michael G. Fara, Maryna Skliut, Christopher Kellner, Reade De Leacy, J Mocco, Stanley Tuhrim, Johanna T. Fifi, “Mobile Interventional Stroke Teams Improve Outcomes in the Early Time Window for Large Vessel Occlusion Stroke”, Stroke, Available August 5, 2021, at https://www.ahajournals.org/doi/abs/10.1161/STROKEAHA.121.034222 Accessed: August 16, 2021.

“Mobile interventional stroke unit improves patient 90-day outcomes” AuntMinnie.com Available August 5, 2021, at https://www.auntminnie.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemID=133148 Accessed: August 16, 2021

“Stroke team travels to patients, resulting in faster treatment and better patient outcomes.” American Heart Association. Available August 5, 2021, at https://newsroom.heart.org/news/stroke-team-travels-to-patients-resulting-in-faster-treatment-and-better-patient-outcomes?preview=e242 Accessed: August 16, 2021.