New York City Mobile Interventional Stroke Team (NYC MIST)

Mount Sinai Health System

Status: Completed

Conditions: Acute Stroke

Treatments: Other: Acute Endovascular Stroke Treatment

Study type: Observational

Funder types: Other

Identifiers

NCT03048292

GCO 16-1290

Details and patient eligibility

About

Endovascular treatment has recently become the recommended therapy for acute stroke after the publication of five randomized trials (MR CLEAN1, ESCAPE2, EXTEND IA3, SWIFT PRIME4, REVASCAT5) in 2015 that demonstrate its efficacy. Hospitals need to adapt to these updated stroke care guidelines, and many hospitals are not appropriately equipped for neurointerventional procedures. Decreased time to treatment is associated with favorable clinical outcomes, and best practices to optimize workflow between comprehensive stroke centers and secondary hospitals have become an important area of study. This prospective study is being conducted on acute stroke cases within the Mount Sinai Health System from 1 June 2016 up until 31 December 2018. The researchers would like to evaluate how variable methods of interventional service delivery for acute stroke affect clinical measures and outcomes.

More specifically, the researchers are conducting this study in order to determine whether outcomes of neurointervention for large vessel occlusion in stroke, for patients presenting to and receiving treatment at a comprehensive stroke center, will be superior to that delivered by a mobilized intervention team at a central satellite hospital. In particular, the hypothesis is that factors affecting outcome include presentation to secondary hospital, delays with transfer including traffic conditions and time of day, and the acquisition of complex imaging within secondary hospitals.

Enrollment: 191 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• all patients who consent to the study and present with acute stroke treated with thrombectomy in the Mount Sinai Health System (Mount Sinai, Mount Sinai West, Mount Sinai Beth Israel, Mount Sinai St. Luke's) from 1 June 2016 - 31 December 2018.

Exclusion criteria

• If the patient is pregnant
• Under age 18
• A prisoner. If timing of treatment cannot be captured, patients with these data points will be excluded.

Trial design

191 participants in 3 patient groups

Mobilized Neurointervention Team

Description:

Patients undergoing endovascular stroke interventions.

Treatment:

Other: Acute Endovascular Stroke Treatment

Mobilized Patient

Treatment:

Other: Acute Endovascular Stroke Treatment

Core Comprehensive Stroke Center Treatment

Treatment:

Other: Acute Endovascular Stroke Treatment