Impact of prehospital stroke video triage (PSVT) on thrombolysis and mechanical thrombectomy rates and reduction in neurological disability and length of stay at University Hospital Southampton

Marigold, Richard, Titmus, Lee and Stonehouse, W. (2025) Impact of prehospital stroke video triage (PSVT) on thrombolysis and mechanical thrombectomy rates and reduction in neurological disability and length of stay at University Hospital Southampton. International Journal of Stroke, 20 (3S), 8-9. (doi:10.1177/17474930251379781).

Abstract

Introduction: 465 patients underwent PSVT between June 2023 and
May 2025. 32 patients received intravenous thrombolysis and 11 mechanical
thrombectomy. We review the results on reperfusion treatment
Method: We examined treatment times, length of stay and neurological
outcomes in patients treated with thrombolysis and thrombectomy and
compared them with SSNAP data for the same period
Results or details of the case: 32 patients underwent thrombolysis.
Door to CT scanning time was halved from 50 min to 26 min. Door to
needle time was 10 minutes faster, reduced from 1:05min to 55min with
video. Stroke onset time to thrombolysis was 45min quicker, and mean
NIHSS 10 pretreatment and 5 post lysis. 20/32 patients were discharged
within 48hrs with minimal disability.
In the thrombectomy group, door to groin puncture times were faster,
pretreatment NIHSS 15 and post 8, with a mean length of stay 4 days and
mean 6-month mRS 2.
Conclusion: PSVT allows prioritisation of reperfusion cases with faster
thrombolysis and thrombectomy times resulting in a greater reduction in
NIHSS and disability with earlier reperfusion treatment, shorter length of
stay and better long-term outcomes. The next challenge is to increase
paramedic and clinician engagement to realise further benefits on patient
outcomes.

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