A pilot program conducted in New York City has shown that a mobile interventional stroke unit improves patient outcomes at 90 days after injury, according to a study published August 5 in Stroke.
The unit was developed by stroke experts at Mount Sinai Health System and was staffed by a neurointerventionalist, a fellow-in-training or a physician assistant, and a radiologic technologist. It traveled to patients experiencing ischemic stroke to perform emergency endovascular thrombectomies rather than transferring them to a higher-level stroke center.
A team led by senior author Dr. Johanna Fifi assessed results from 226 stroke patients who underwent endovascular thrombectomy between January 2017 and February 2020. Of these, 106 were treated by the mobile interventional stroke team (MIST), and 120 were treated at the hospital. The group compared 90-day functional outcomes between the two patient groups, tracking results by treatment within six hours of stroke onset and six hours after.
The researchers found the following:
- Patients treated within six hours of stroke onset with the mobile unit had a higher good outcome rate at 90 days postevent compared to those in the transferred group (54% versus 28%).
- Functional outcomes in patients treated by the mobile unit within six hours of stroke onset were better than transferred patients.
- Patients treated six hours or more after stroke onset had similar outcomes: 35% of mobile unit treated patients had good 90-day outcomes, while 41% of transferred patients had good three-month outcomes.
"Ischemic strokes often progress rapidly and can cause severe damage because brain tissue dies quickly without oxygen, resulting in serious long-term disabilities or death," Fifi said in a statement released by the American Heart Association, publisher of the journal. "Assessing and treating stroke patients in the early window means that a greater number of fast-progressing strokes are identified and treated."
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
