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NASHVILLE, Tenn. -- The nation's first mobile stroke treatment units significantly reduced alarm-to-treatment times in two pilot studies.

Sixteen of the first 100 patients transported by a dedicated stroke ambulance operated by Cleveland Clinic received tissue plasminogen activator (tPA) treatment, and door-to-tPA times averaged 31 minutes compared with 60 minutes for controls, reported , of the Cleveland Clinic Stroke Program, and colleagues at the International Stroke Conference.

In a separate study, , project manager for the operated by the University of Texas Health Science Center in Houston, reported early data from an ongoing study of that program.

Mobile stroke units began operating last spring in Houston, and the started up last July.

Mobile stroke treatment units are specialized ambulances staffed with a critical care nurse, paramedic, and CT technologist in contact via two-way conferencing with a stroke physician. The units are equipped with CT scanners, lab equipment, tPA, and other treatments to facilitate diagnosis and treatment before hospital arrival.

During the first 3 weeks of use, the Cleveland Clinic mobile stroke unit transported and treated 23 patients, Hussain said.

Compared with a control group of 34 stroke patients brought to the emergency department (ED) in traditional ambulances during the preceding 3 months, there was a significant reduction in CT scan and time to treatment (alarm to thrombolysis time) associated with mobile stroke unit transport.

Specifically, the median time from alarm to CT scan completion among the mobile stroke unit patients was 41 minutes versus 62 minutes for patients transported via traditional ambulance.

The median time to treatment was 64 minutes with the mobile stroke unit compared with 104 minutes in the control group.

Six patients in the study group received tPA versus five who were transported to the ED in traditional ambulances.

The median time for alarm-to-mobile stroke unit arrival was 13 minutes.

"On average we have been seeing about a 40-minute reduction in time to treatment," Hussain told 麻豆传媒.

No early complications of thrombolysis were reported in the mobile stroke unit group, the authors stated.

The Houston mobile stroke unit has a neurologist on board the vehicle along with a critical care nurse, a CT technologist, and a paramedic. Another stroke specialist makes diagnostic and treatment assessments via telemedicine and is blinded to the assessments of the onsite physician.

This is being done to test the efficacy of the telemedicine aspect of the program, Parker said.

She reported that the mobile stroke unit treated its first patient in May 2014, and is able to provide acute stroke treatment within 10 to 18 minutes of on-location arrival.

About two patients were treated with tPA per week on the mobile stroke unit during a 9-week run-in period, with 40% treated within 1 hour of symptom onset, Parker said.

"The Houston Fire Department has an average (pre-transport) on-scene time of 15 to 18 minutes, and ours is around 21 to 24," she said. "But during that time, we are doing labs and CT scans and getting IVs in and starting other treatments. We do all this before leaving the scene and the treatment is running while we are on the way to the hospital."

The unit averages about two to six runs a day, but many of these turn out to be nonstroke related, Parker explained, adding that "we are averaging about one tPA treatment per 10 runs."

The ultimate goal, she said, is to show that the mobile stroke unit improves patient outcomes over traditional transport.

There's no cost analysis data available for either the Houston or Cleveland programs, but Parker told 麻豆传媒 said it would not be cost effective to have a neurologist on board the mobile stroke unit at all times.

Data on patient outcomes and the program's cost effectiveness should be available in about 2 years, she added.