{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T05:35:21Z","timestamp":1769146521060,"version":"3.49.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2014,7,15]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Meaningful delays occurred in the Interventional Management of Stroke (IMS) III trial. Analysis of the work flow will identify factors contributing to the in-hospital delays.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>In the endovascular arm of the IMS III trial, the following time intervals were calculated: stroke onset to emergency department arrival; emergency department to computed tomography (CT); CT to intravenous tissue plasminogen activator start; intravenous tissue plasminogen activator start to randomization; randomization to groin puncture; groin puncture to thrombus identification; thrombus identification to start of endovascular therapy; and start of endovascular therapy to reperfusion. The effects of enrollment time, CT angiography use, interhospital transfers, and intubation on work flow were evaluated. Delays occurred notably in the time intervals from intravenous tissue plasminogen activator initiation to groin puncture (median 84 minutes) and start of endovascular therapy to reperfusion (median 85 minutes). The CT to groin puncture time was significantly shorter during working hours than after. Times from emergency department to reperfusion and groin puncture to reperfusion decreased over the trial period. Patients with CT angiography had shorter emergency department to reperfusion and onset to reperfusion times. Transfer of patients resulted in a longer onset to reperfusion time compared with those treated in the same center. Age, sex, National Institutes of Health Stroke Scale score, and intubation did not affect delays.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Important delays were identified before reperfusion in the IMS III trial. Delays decreased as the trial progressed. Use of CT angiography and endovascular treatment in the same center were associated with time savings. These data may help in optimizing work flow in current and future endovascular trials.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00359424.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.113.007826","type":"journal-article","created":{"date-parts":[[2014,5,10]],"date-time":"2014-05-10T02:20:32Z","timestamp":1399688432000},"page":"265-272","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":92,"title":["Evaluation of Interval Times From Onset to Reperfusion in Patients Undergoing Endovascular Therapy in the Interventional Management of Stroke III Trial"],"prefix":"10.1161","volume":"130","author":[{"given":"Mayank","family":"Goyal","sequence":"first","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Almekhlafi","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqiong","family":"Fan","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bijoy K.","family":"Menon","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew M.","family":"Demchuk","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon D.","family":"Yeatts","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Hill","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Tomsick","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja","family":"Khatri","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama O.","family":"Zaidat","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward C.","family":"Jauch","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muneer","family":"Eesa","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor G.","family":"Jovin","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph P.","family":"Broderick","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada (M.G., M.A.A., B.K.M., A.M.D., M.D.H., M.E.); Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (M.A.A.); Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.F., S.D.Y.); Departments of Neurology and Radiology, University of Cincinnati, Cincinnati, OH (T.T., P.K., J.P.B.); Department of Radiology, Medical College of..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60491-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181b9c847"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000258112.14918.24"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2012-010486"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60738-7"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.594481"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3276"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.112.670687"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a4a4d2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31825d6011"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.113.002522"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214300"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2008.00151.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.974675"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.112.000506"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010868"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3770"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61299-9"},{"key":"e_1_3_3_20_2","first-page":"1747","article-title":"SOLITAIRE with the intention for thrombectomy (SWIFT) trial: design of a randomized, controlled, multicenter study comparing the SOLITAIRE Flow Restoration device and the Merci Retriever in acute ischaemic stroke.","author":"Saver JL","year":"2012","unstructured":"Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira R, Clark W, Budzik R, Zaidat OO; 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