Stroke: Importance of Workflow

Stroke: The importance of workflow

When a patient suffers a stroke, speed in treatment can mean the difference between successful recovery, permanent disability, or death. Often encapsulated in the phrase "time equals brain", the ability to act quickly and with greater certainty enables physicians to bring a higher quality of life for those who survive. For Christopher Hess, MD, PhD, success in stroke diagnosis and impactful treatment therefore is a question of workflow and efficient care delivery.

Report: Sascha Keutel

'Effective treatment of stroke depends critically on workflow and the overall strategy for how patients are evaluated and treated,' the Chairman of the Department of Radiology and Biomedical Imaging at the University of California, San Francisco (UCSF), said.


For Dr. Hess, new and emerging multimodality angiography suites that include MRI and cone-beam CT hold significant promise for stroke patients. 'We have a closely located MRI and angiography suite at Zuckerberg San Francisco General Hospital that we use to decide in real-time how to process with embolectomy. Our other imaging resources like effective hub-and-spoke imaging tranfer tools, fast emergency department CT and cone-beam CT in the angiography suite are essential to rapidly make sure the patient doesn’t have a hemorrhage before embolectomy proceeds,' he reported.


This technological advantage directly affects workflow at UCSF, because it can allow patients with large vessel occlusion to avoid going through the ER, the expert explained. 'Patients are transferred directly into the the hands of our neurointerventionalists to start the procedure,' the neuroradiologist said. 'This is important, because the clock is always ticking in stroke therapy.'

Time is also of the essence when thrombolysis is performed using tissue plasminogen activate (tPA) in patients with large-vessel occlusion. The tPA protein, which is used to dissolve the clot, must be given intravenously within a four-and-a-half hour window from the onset of symptoms to ensure treatment success.