부산대학교 도서관

In a mechanical thrombectomy for acute major cerebral artery occlusion, it is important to shorten the time from the patient’s arrival to the puncture (i.e., the door‒to‒puncture [D2P] time). Perfusion imaging and a mismatch analysis using fully automated (rapid processing of perfusion and diffusion [RAPID]) cerebral perfusion imaging software were introduced at our institution, and there was concern that the D2P time would be extended because more time is required for the RAPID software’s image acquisition. We compared the impact of using the RAPID program on the D2P time. The subjects were 125 consecutive patients who underwent a mechanical thrombectomy for an acute ischemic infarction with cerebral artery occlusion during the period August 2018 to January 2023. There were 56 patients in the pre‒RAPID group and 69 patients in the post‒RAPID group, and 65 (94%) of the post‒RAPID patients underwent CT perfusion or MRI perfusion. The median D2P time (IQR) was 74 (61‒93) min in the post‒RAPID group, which was 15 min shorter than the 89 (66‒102) min in the post‒RAPID group (p＜0.05). Shortening of the D2P time is believed to contribute to the clinical outcomes of mechanical thrombectomy for acute cerebral artery occlusion, and although there was concern that the use of the RAPID software would extend the D2P time, the present results demonstrated that the D2P time was shortened after the introduction of RAPID. A possible reason for the shortened D2P time is that the introduction of RAPID software enabled early diagnoses, early indication judgments, and the visualization of treatment goals, as did our implementation of measures to shorten the D2P time such as reviewing the stroke hotline system and the hospital system. The RAPID software may thus be useful for shortening the D2P time.