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Clinical Neuroradiology

, Volume 28, Issue 4, pp 473–480 | Cite as

Stroke Transfer and its Organizational Paradigm

Review of Organizational Paradigms and the Impact on Outcome
  • Lili Détraz
  • Marielle Ernst
  • Romain Bourcier
Review Article
  • 95 Downloads

Abstract

Since the clinical recognition of endovascular therapy (EVT) for stroke treatment is recent (2015), some organizational issues, such as the “drip and ship (DS) versus mothership (MS)” access to EVT remain unanswered. There is growing pressure to guarantee immediate access to EVT with limited human resources and infrastructures. As results from prospective studies are missing, a review of the existing literature dealing with clinical retrospective studies was carried out. Most of the studies did not report a significant difference with respect to the adverse effects for patients treated by EVT according to the organizational paradigm of care. Several studies did not report a significant difference concerning the 3 months functional outcomes regarding the organizational paradigm. Only two studies built theoretical models of the best outcomes and observed a superiority of the DS only if the door to needle time was less than 30 min. Waiting for the results of ongoing randomized controlled trials, this review of articles presenting patients treated with either MS or DS provides an overview but does not emphasize a superiority of a given paradigm; however, it highlights the inequalities of access to EVT according to the organization of care in different areas.

Keywords

Mother ship Drip and ship Organization Endovascular treatment Systematic review 

Notes

Conflict of interest

L. Détraz, M. Ernst and R. Bourcier declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional NeuroradiologyGuillaume et René Laennec University HospitalNantesFrance
  2. 2.Radiology DepartmentUniversity of Hamburg-EppendorfHamburgGermany

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