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Mobile Stroke Units: Current Evidence and Impact

  • Stroke (B. Ovbiagele, Section Editor)
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Abstract

Purpose of Review

Several approaches have been developed to optimize prehospital systems for acute stroke given poor access and significant delays to timely treatment. Specially equipped ambulances that directly initiate treatment, known as Mobile Stroke Units (MSUs), have rapidly proliferated across the world. This review provides a comprehensive summary on the efficacy of MSUs in acute stroke, its various applications beyond thrombolysis, as well as the establishment, optimal setting and cost-effectiveness of incorporating an MSU into healthcare systems.

Recent Findings

MSUs speed stroke treatment into the first “golden hour” when better outcomes from thrombolysis are achieved. While evidence for the positive impact of MSUs on outcomes was previously unavailable, two recent landmark controlled trials, B_PROUD and BEST-MSU, show that MSUs result in significantly lesser disability compared to conventional ambulance care.

Summary of Review

Emerging literature prove the significant impact of MSUs. Adaptability however remains limited by significant upfront financial investment, challenges with reimbursements and pending evidence on their cost-effectiveness.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Neurology, McGovern Medical School at the University of Texas Health Science Center, 6431 Fannin St, MSB 7.044, Houston, TX, 77030, USA

    Praveen Hariharan, Muhammad Bilal Tariq & Alexandra L. Czap

  2. Clinical Innovation and Research Institute, Memorial Hermann Hospital Texas Medical Center, Houston, TX, USA

    James C. Grotta

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  1. Praveen Hariharan
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  2. Muhammad Bilal Tariq
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Correspondence to Alexandra L. Czap.

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Grotta receives Research Grant from Genentech, CSL Behring, NIH, PCORI and is Consultant/Advisory Board member at Frazer Ltd. The other authors report no conflicts.

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Hariharan, P., Tariq, M.B., Grotta, J.C. et al. Mobile Stroke Units: Current Evidence and Impact. Curr Neurol Neurosci Rep 22, 71–81 (2022). https://doi.org/10.1007/s11910-022-01170-1

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