Which statement best distinguishes door-to-needle time from door-to-groin time in acute ischemic stroke care?

Which statement best distinguishes door-to-needle time from door-to-groin time in acute ischemic stroke care?

• A. Door-to-needle is the time to CT scanner gate; door-to-groin is the time to OR readiness.
• B. Door-to-needle is the time from hospital arrival to initiation of IV tPA; door-to-groin is the time to arterial access for thrombectomy.
• C. Door-to-needle measures time to imaging; door-to-groin measures time to hospital discharge.
• D. Door-to-needle equals time to arterial access; door-to-groin equals time to IV tPA infusion.

Answer: (B)

This item tests understanding of timing milestones for two stroke treatment paths: IV thrombolysis versus endovascular therapy. Door-to-needle is the time from hospital arrival to the initiation of IV tPA, meaning how quickly the patient begins thrombolysis after arriving. Door-to-groin is the time from arrival to arterial access at the groin (femoral artery) to start a catheter-based thrombectomy. In other words, one metric tracks speed to IV medication, while the other tracks speed to begin an endovascular procedure. This distinction is why the statement describing door-to-needle as the time to IV tPA initiation and door-to-groin as the time to arterial access for thrombectomy is the best fit. The other choices mix up what is being timed (imaging, discharge, or different endpoints) and don’t reflect the actual endpoints for these two treatment pathways.

This item tests understanding of timing milestones for two stroke treatment paths: IV thrombolysis versus endovascular therapy. Door-to-needle is the time from hospital arrival to the initiation of IV tPA, meaning how quickly the patient begins thrombolysis after arriving. Door-to-groin is the time from arrival to arterial access at the groin (femoral artery) to start a catheter-based thrombectomy. In other words, one metric tracks speed to IV medication, while the other tracks speed to begin an endovascular procedure. This distinction is why the statement describing door-to-needle as the time to IV tPA initiation and door-to-groin as the time to arterial access for thrombectomy is the best fit. The other choices mix up what is being timed (imaging, discharge, or different endpoints) and don’t reflect the actual endpoints for these two treatment pathways.