Rendezvous transport plus prehospital computed tomography angiography on mobile stroke unit for large vessel occlusion: Achieving 103 min call-to-puncture time in 106 km distance

Aim Investigate the role of mobile stroke unit (MSU) and rendezvous transport with emergency medical service (EMS) in timely large vessel occlusion (LVO) identification and direct transfer to the comprehensive stroke center. Methods The fifth-generation MSU (5G-MSU) program was first implemented in 2019, directly dispatched through the 120 emergency medical services. The rendezvous transport was initiated in 2020. We report the first case of rendezvous transport plus prehospital computed tomography angiography (CTA) on 5G-MSU for endovascular treatment of LVO. Results A 5G-MSU was dispatched for a patient with reported right-sided hemiparesis and reduced consciousness at a primary stroke center, located at a distance of 106 km. The 5G-MSU and EMS coordinated a rendezvous transport to transfer the patient. CTA performed on the 5G-MSU revealed basilar artery occlusion, prompting immediate contact with the main hospital's angiography suite. Upon arrival, the patient was directly transferred to the angiography suite for endovascular therapy, achieving successful recanalization. Consequently, the call-to-puncture time was successfully achieved within 103 min, across a distance of 106 km. Discussion Rendezvous transport combined with prehospital CTA on the 5G-MSU in rural areas is feasible. This approach allows the MSU to extend beyond its conventional treatment coverage, rapidly identify large vessel occlusions, and thereby significantly reduce call-to-treatment time.