PDF(Pubmed)
Abstract：
UNASSIGNED: Mechanical thrombectomy is a time-sensitive treatment, with rapid initiation and reduced delays being associated with better patient outcomes. Several systematic reviews reported on various interventions to address delays. Hence, we performed an umbrella review of systematic reviews to summarise the current evidence.
UNASSIGNED: Medline, Embase, Cochrane Library and JBI were searched for published systematic reviews. Systematic Reviews that detailed outcomes related to time-to-thrombectomy or functional independence were included. Methodological quality was assessed using the JBI critical appraisal tool by two independent reviewers.
UNASSIGNED: A total of 17 systematic reviews were included in the review. These were all assessed as high-quality reviews. A total of 13 reviews reported on functional outcomes, and 12 reviews reported on time-to-thrombectomy outcomes. Various interventions were identified as beneficial. The most frequently reported beneficial interventions that improved functional and time-related outcomes included: direct-to-angio-suite and using a mothership model (compared to drip-and-ship). Only a few studies investigated other strategies including other pre-hospital and teamwork strategies.
UNASSIGNED: Overall, there were various strategies that can be used to reduce delays in the delivery of mechanical thrombectomy with different effectiveness. The mothership model appears to be superior to the drip-and-ship model in reducing delays and improving functional outcomes. Additionally, the direct-to-angiosuite approach appears to be beneficial, but further research is required for broader implementation of this approach and to determine which groups of patients would benefit the most.
UNASSIGNED: Medline, Embase, Cochrane Library and JBI were searched for published systematic reviews. Systematic Reviews that detailed outcomes related to time-to-thrombectomy or functional independence were included. Methodological quality was assessed using the JBI critical appraisal tool by two independent reviewers.
UNASSIGNED: A total of 17 systematic reviews were included in the review. These were all assessed as high-quality reviews. A total of 13 reviews reported on functional outcomes, and 12 reviews reported on time-to-thrombectomy outcomes. Various interventions were identified as beneficial. The most frequently reported beneficial interventions that improved functional and time-related outcomes included: direct-to-angio-suite and using a mothership model (compared to drip-and-ship). Only a few studies investigated other strategies including other pre-hospital and teamwork strategies.
UNASSIGNED: Overall, there were various strategies that can be used to reduce delays in the delivery of mechanical thrombectomy with different effectiveness. The mothership model appears to be superior to the drip-and-ship model in reducing delays and improving functional outcomes. Additionally, the direct-to-angiosuite approach appears to be beneficial, but further research is required for broader implementation of this approach and to determine which groups of patients would benefit the most.
摘要：
■机械血栓切除术是一种时间敏感的治疗方法，快速启动和减少延迟与更好的患者预后相关。一些系统审查报告了解决延误的各种干预措施。因此，我们对系统评价进行了全面回顾，以总结当前的证据。
■Medline，Embase,搜索CochraneLibrary和JBI以获取已发表的系统评价。包括与血栓切除时间或功能独立性相关的详细结果的系统评论。由两名独立的审稿人使用JBI批判性评估工具评估方法学质量。
■共有17篇系统综述被纳入综述。这些都被评估为高质量的评论。共有13项审查报告了功能成果，以及12篇关于取栓时间结局的综述.各种干预措施被认为是有益的。最常报告的改善功能和时间相关结果的有益干预措施包括：直接到血管套件和使用母船模型（与滴水和船相比）。只有少数研究调查了其他策略，包括其他院前和团队合作策略。
■总的来说，有不同的策略可用于减少不同有效性的机械血栓切除术的延迟.在减少延误和改善功能结果方面，母船模型似乎优于滴水模型。此外,直接到血管套房的方法似乎是有益的，但需要进一步的研究才能更广泛地实施这种方法，并确定哪些患者组将受益最多。
■Medline，Embase,搜索CochraneLibrary和JBI以获取已发表的系统评价。包括与血栓切除时间或功能独立性相关的详细结果的系统评论。由两名独立的审稿人使用JBI批判性评估工具评估方法学质量。
■共有17篇系统综述被纳入综述。这些都被评估为高质量的评论。共有13项审查报告了功能成果，以及12篇关于取栓时间结局的综述.各种干预措施被认为是有益的。最常报告的改善功能和时间相关结果的有益干预措施包括：直接到血管套件和使用母船模型（与滴水和船相比）。只有少数研究调查了其他策略，包括其他院前和团队合作策略。
■总的来说，有不同的策略可用于减少不同有效性的机械血栓切除术的延迟.在减少延误和改善功能结果方面，母船模型似乎优于滴水模型。此外,直接到血管套房的方法似乎是有益的，但需要进一步的研究才能更广泛地实施这种方法，并确定哪些患者组将受益最多。
