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It summarizes process improvements, mentorship via Tele-fluoroscopy, regional access through EMS bypass and “drip and ship,” and pilot outcomes versus Canadian ESCAPE trial metrics.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/endovascular-thrombectomyin-hyperacute-stroke-care-final-pilot-evaluation-report-august-2017/506450/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/endovascular-thrombectomyin-hyperacute-stroke-care-final-pilot-evaluation-report-august-2017/506450.png","ImageObject",300,407,{"name":42,"@type":43},"lilac","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-08","2026-10-05",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What clinical and imaging criteria were used to determine EVT eligibility?","Question",{"text":62,"@type":63},"Eligibility was based on the clinical presentation combined with specific brain and vascular imaging, including CT head and multiphase CT angiography.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Why was EVT pilot implementation needed at KGH?",{"text":67,"@type":63},"KGH did not participate in the 2015 research trials because the body interventional radiologists were not neuro-trained, and the pilot aimed to assess feasibility of EVT delivery at KGH.",{"name":69,"@type":60,"acceptedAnswer":70},"What outcomes and process improvements were reported for the 10-case pilot?",{"text":71,"@type":63},"Eight of ten cases showed improved function at acute discharge, with 6/10 having minimal to no disability at 90-day follow-up (MRS ≤ 2). Process times, including picture-to-puncture-to-reperfusion, were reported as well ahead of trial targets.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},506450,1791275589,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},7,"Healthcare",40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},8,30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},3985747861865,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","| | |\n| --- | --- |\n| Final Pilot Evaluation Report\u003Cbr>Endovascular Thrombectomyin Hyperacute Stroke Care:\u003Cbr>improving outcomes for those with severe stroke across Southeastern Ontario\u003Cbr>August 2017\u003Cbr>Kingston Health Sciences Centre (KHSC) Kingston General Hospital (KGH) Site\u003Cbr>Submitted by:\u003Cbr>The KHSC-KGH Stroke Endovascular Thrombectomy (EVT) Workgroup-membership list in Appendix A\u003Cbr>Dr. Albert Yongwon Jin, Stroke Neurologist and Medical Lead, Stroke Network of SEO Karen Pearson, Director, Diagnostic Imaging Services\u003Cbr>Dr Annette McCallum, Head, Radiology\u003Cbr>Cally Martin, Regional Director, Stroke Network of Southeastern Ontario (SEO)\u003Cbr>To:\u003Cbr>KGH Executive Sponsor(s): Mike McDonald, VP Patient Care\u003Cbr>Dr Michael Fitzpatrick, Chief of Staff\u003Cbr>|  |\n\n1.0 Executive Summary  \nBackground  \nFive landmark trials supporting Endovascular Thrombectomy were published in 2015 supporting this treatment asa new standard of care and included in the Canadian Best Practice Recommendations for stroke care in July 2015. This had significant regional implications for KHSC-KGH as one of Ontario’s nine designated Regional Stroke Centres (RSCs) . KHSC-KGH did not participate in the research trials because, despite significant supra-aortic experience, the KGH body interventional radiologists were not neuro-trained. This treatment consists of arterial catheterization and mechanical removal of large clots occluding brain vessels using a micro-catheter and retrieval stent thus promoting reperfusion of the circulation by recanalization of the artery. The evidence supports significant improvement in functional outcomes for select patients with large proximal clots. The outcomes for these select patients are poor with IV thrombolysis alone. The endovascular treatment can be given with or without IV thrombolysis and is the only treatment available for patients with contraindications to IV tPA (e.g. due to bleeding risk) . EVT also has a longer time window of 7.3 hours versus 4.5 hours for thrombolysis; however, the sooner treatment is delivered the better the outcomes. Cases transported to Ottawa or Toronto have arrived too late to benefit. Eligibility for treatment is based on clinical presentation combined with specific brain and vascular imaging (CT head and multiphase CT angiography) .  \nKHSC EVT Pilot  \nApproval: In June 2015 the Senior Leadership Team at KGH supported the formation of an inclusive multidisciplinary and interprofessional EVT Workgroup to assess the feasibility of EVT delivery at KGH. The Workgroup mapped the process flow for EVT patients from pre-hospital care, through ED, DI, IVR, and Kidd 2 Critical Care to the Kidd 7 Acute Stroke Unit. A business case for EVT delivery at KGH was developed for both daytime and 24/7 service delivery. In Dec 2015, a presentation was made to the KGH Planning and Performance Committee asking for senior leadership approval to plan and implement a Pilot of 10 EVT cases at KGH over the 2016/17 fiscal year. Given EVT was not yet publicly funded, a funding source was identified through a deferred stroke project fund. The Pilot was approved for daytime cases 8am to 4pm with the understanding that if successful, learning would be applied to planning 24/7 service delivery. It was understood that 24/7 service delivery would require significant resources from the IVR suite.  \nA project plan was delivered. Education was provided, care processes and order sets were developed and an innovative mentorship model was established with Hamilton using Tele-fluoroscopy. The Pilot was launched May 2016. Indicators were monitored; debriefs were held on every case and informed continuous improvements. Workflow improvements were made; for example, median thrombolysis Door-to-Needle time was reduced from 41 to 19 minutes. Ten 10 anterior circulation cases were completed by May 2017.  \nRegional Access: The Pilot included several patients on EMS bypass to KGH for thrombolysis from community hospitals (e.g. Napanee, Broc","cbCaia3Bn7FI9umK","https://ap.wps.com/l/cbCaia3Bn7FI9umK","pdf",1215192,22,"English","# 1.0 Executive Summary\n## Background\n## KHSC EVT Pilot\n## Regional Access\n## KHSC Pilot Outcomes\n## Stroke EVT Funding","[{\"question\":\"What clinical and imaging criteria were used to determine EVT eligibility?\",\"answer\":\"Eligibility was based on the clinical presentation combined with specific brain and vascular imaging, including CT head and multiphase CT angiography.\"},{\"question\":\"Why was EVT pilot implementation needed at KGH?\",\"answer\":\"KGH did not participate in the 2015 research trials because the body interventional radiologists were not neuro-trained, and the pilot aimed to assess feasibility of EVT delivery at KGH.\"},{\"question\":\"What outcomes and process improvements were reported for the 10-case pilot?\",\"answer\":\"Eight of ten cases showed improved function at acute discharge, with 6/10 having minimal to no disability at 90-day follow-up (MRS ≤ 2). Process times, including picture-to-puncture-to-reperfusion, were reported as well ahead of trial targets.\"}]","Endovascular Thrombectomyin Hyperacute Stroke Care - Final Pilot Evaluation Report - August 2017 | PDF",1791165415,55]