New Search

Export article
Open Access

Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy

Takeshi Hiu, Shimpei Morimoto, Ayaka Matsuo, Kei Satoh, Hiroaki Otsuka, Fumiya Kutsuna, Keisuke Ozono, Kosuke Hirayama, Chikaaki Nakamichi, Kazumi Yamasaki, Yuka Ogawa, Eri Shiozaki, Yoichi Morofuji, Ichiro Kawahara, Nobutaka Horie, Yohei Tateishi, Tomonori Ono, Wataru Haraguchi, Tsuyoshi Izumo, Akira Tsujino, Takayuki Matsuo, Keisuke Tsutsumi
Published: 19 January 2021
PLOS ONE , Volume 16; doi:10.1371/journal.pone.0245082

Abstract: Background Mechanical thrombectomy (MT) is standard treatment for acute ischemic stroke (AIS) with large-vessel occlusion within 6 h of symptom onset to treatment initiation (OTP). Recent trials have extended the therapeutic time window for MT to within 24 h. However, MT treatment remains low in remote areas. Nagasaki Prefecture, Japan has many inhabited islands with no neurointerventionalists. Our hospital on the mainland is a regional hub for eight island hospitals. We evaluated clinical outcomes of MT for patients with AIS on these islands versus on the mainland. Methods During 2014–2019, we reviewed consecutive patients with AIS who received MT at our hospital. Patients comprised the Islands group and Mainland group. Patient characteristics and clinical outcomes were compared between groups. Results We included 91 patients (Islands group: 15 patients, Mainland group: 76 patients). Seven patients (46.7%) in the Islands group versus 43 (56.6%) in the Mainland group achieved favorable outcomes. Successful recanalization was obtained in 11 patients (73.3%) on the islands and 67 (88.2%) on the mainland. The median OTP time in the Islands was 365 min. In both the Islands and Mainland groups, the OTP time and successful recanalization were associated with functional outcome. The modified Rankin Scale (mRS) score at 90 days ≤2 was obtained in two patients and mRS = 3 in four patients among eight patients with OTP time >6 h. Conclusions Few patients with AIS on remote islands have received MT. Although patients who underwent MT on the islands had longer OTP, the clinical outcomes were acceptable. OTP time on remote islands must be shortened, as this is related to functional outcome. In some cases with successful recanalization, a favorable outcome can still be obtained even after 6 h. Even if OTP exceeds 6 h, it is desirable to appropriately select patients and actively perform MT.
Keywords: magnetic resonance imaging / stroke / Islands / Computed axial tomography / Hemorrhage / Radiology and Imaging / ISCHEMIC stroke / infarction

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

Share this article

Click here to see the statistics on "PLOS ONE" .
References (25)
    Back to Top Top