Background and Objective: Use of Computed Tomographic Perfusion (CTP) imaging at a referring hospital may help triage and shorten door-to-puncture time for patients with acute ischemic stroke.
Methods: We conducted a single center retrospective review of a prospectively maintained database of consecutive ischemic stroke patients transferred to our center for consideration of endovascular therapy. Patients were divided into two groups. Group 1 consisted of patients transferred from a facility where CTP (using automated RAPID software) was routinely performed and group 2 consisted of patients transferred from a facility that did not perform perfusion imaging.
Results: We identified a total of 132 patients all of whom were transferred to our center from April of 2014 to April of 2017. There were no differences in baseline characteristics between two groups. A total of 34 patients were transferred from a facility with RAPID CTP (Group 1) and 98 were transferred from a facility with no CTP (Group 2). Door-to-puncture time was significantly lower for patients in Group 1 compared with Group 2 (median [IQR], 12 [8 - 16] minutes and 48.5 [32.8 - 71.8] minutes, p<.001). Despite having additional imaging in Group 1, there was no difference in door-in and door-out times at the referring facilities compared with group 2.
Conclusions: We found that triaging from a primary stroke center with CTP ability significantly reduced door-to-puncture time as compared with transferred patients with no perfusion imaging without any significant delay in transfer process.