Mobile stroke units have recently been deployed in a few communities around the U.S., but the world's first unit with a hospital-grade CT angiography scanner was introduced today at The University of Tennessee College of Medicine in Memphis.

The unit is equipped with the Siemens SOMATOM Scope CT scanner that can evaluate both brain and blood vessels. It will allow clinicians to diagnose and administer treatments — including tissue plasminogen activator (tPA) and the blood pressure drug, nicardipine — within the first hour upon arriving on the scene.

"In the past couple of years we learned that we should be giving tPA, but we also should be bringing patients to the cath lab," Dr. Andrei V. Alexandrov, the chairman of the department of neurology at The University of Tennessee Health Science Center, told HCB News. "The only technology that would allow both is to deploy a CT scanner capable of CT angiography."




Other mobile stroke units are only able to prepare the patient for the emergency room, but the university's mobile stroke unit bypasses the ER and preps the patient to go straight to the cath lab, neuro intensive care unit or the hospital stroke unit.

Eliminating the need to get to and have the patient go through the ER can save up to 90 minutes. The more time that is saved, the less likely that the patient will suffer from permanent brain damage.

Shelby County, Tennessee has a stroke rate per 100,000 population, which is 37 percent higher than the national average.

The unit will be based in a 10-mile radius in Memphis with the highest incidence of stroke, but it can also be deployed within the entire metropolitan area. Alexandrov estimates that 300 patients will have to be treated by the unit to prove its effectiveness over the next three years.

For other institutions that are considering deploying a mobile stroke unit, Alexandrov said that geography is a very important consideration. Memphis is easy to drive around, but in New York, with busy streets, and West Virginia with the mountains, it's a much different scenario.

The end user providing the service also needs to be taken into consideration because the scenarios are different for a single hospital system or a physician practice and academic practice that delivers patients to competing institutions.

"We decided to be able to pick up any patient anywhere and bring them to the destination of their choice, and to go to competing institutions," said Alexandrov. "We are not constrained by distances to just one institution."