Bordeaux: at the University Hospital, the stroke care unit integrated into the emergency department, a first in France

Bordeaux University Hospital is the second-largest center in France for stroke treatment, after Lille University Hospital. It will now be the first to have a dedicated interventional imaging room, integrated into the emergency department. An additional opportunity for patients

With nearly 380 people suffering a stroke each year, Bordeaux University Hospital is the leading hospital in France in treating these serious conditions, which affect 140,000 people every year. A true public health scourge, stroke requires the fastest and most effective treatment possible to limit the consequences, which can be devastating, leaving many patients disabled. "While we are second behind Lille University Hospital in terms of the number of patients treated, we did not score well at all in terms of treatment time," acknowledges Dr. Xavier Barreau, a neuroimaging radiologist at Pellegrin Hospital in Bordeaux. "To transport patients from the emergency room to the interventional imaging room, then to the operating room or the resuscitation unit, we had to go through corridors, swinging doors, and elevators." However, to guarantee the patient the best chance of retaining their brain functions following a stroke, we must act very quickly."

Six hours. No more. To unblock a vessel after a stroke, to save the patient's neurons, this threshold must not be exceeded: "beyond that, the prognosis collapses," the doctor points out. "Unity of space has long been a goal of the CHU. Medicine, technology, and practices have evolved faster than architecture. But, finally, we're there." This June, the CHU opened an interventional imaging room integrated into the hospital's emergency department, wedged between the resuscitation room and the operating room. A first in France. Dr. Eva Jambon, an interventional radiologist on the team, applauds this tool, which, in addition to saving precious time for patients, is equipped with the latest high-tech equipment.

Now, a simple corridor and two swinging doors allow you to move from one room to another in the emergency room. There are no more floors, no more elevators, no more waiting. "Walking 100 or 200 meters in a hospital with an unstable patient in great danger on a stretcher is complicated," notes Dr. Barreau. "We've saved time, our goal is to go faster and faster between diagnosis and intervention: 30 minutes. In Northern Europe, they're at 25 minutes." When a person is taken to the emergency room for a suspected stroke, they sometimes come from far away, since the university hospital is a regional referral center. Time has already passed for transport. Once there, everything moves very quickly. After a consultation, she will undergo imaging tests, scanner or MRI, then once the diagnosis has been made, she will be taken in a few minutes to this new interventional imaging "block", equipped with an innovative system allowing specialists to observe the state of the brain, thanks to a 3D guided imaging system.

"We can see the brain from all angles, with two cameras and a high-resolution image," comments Dr. Barreau. "The room is fully motorized, and the visualization system is combined with another injection system. Comfort for both the patient and practitioners is maximized. Every second counts before the vessel is reopened by thrombectomy, the technique that unblocks the artery." The new room will also allow for the treatment of people traumatized following an accident with serious hemorrhage, as well as postpartum hemorrhage in women during childbirth. The CHU treats approximately 500 trauma patients each year who are victims of hemorrhage. "Furthermore," adds Dr. Eva Jambon, "patients suffering from urgent aortic pathology will also benefit from endovascular care in this room, and they too will benefit from highly efficient technology. Our practice is relatively recent; little by little, we are changing our behaviors and our practices." Integrating the interventional imaging room into the emergency room, right next to the operating room, is a no-brainer and a blessing for patients. Furthermore, we were a bit isolated on the floors before. Working together as a team is more comfortable because it's reassuring.

Bordeaux University Hospital called on experts to create this completely innovative room, an investment of €2.37 million, split between construction and equipment. Each year, the public institution allocates a budget of €8 million to biomedical equipment, to help improve patient care.