Effect of time delay in inter-hospital transfer on outcomes of endovascular treatment of acute ischemic stroke

• DOI: 10.3389/fneur.2023.1303061
• Publication Date: 2023-12-22T04:45:29Z
• Authors: Keshet Pardo; Jonathan Naftali; Rani Barnea; Michael Findler; Alain Perlow; Ran Brauner; Eitan Auriel; Guy Raphaeli
• Keywords: Stroke; Single Center; Clinical endpoint

Background Endovascular treatment (EVT) with mechanical thrombectomy is the standard of care for large vessel occlusion (LVO) in acute ischemic stroke (AIS). The most common approach today to perform EVT a comprehensive center (CSC) and transfer relevant patients from primary (PSC). Rapid efficient LVO key factor achieving good clinical outcome. Methods We present our retrospective cohort who underwent between 2018 2021, including direct admissions transferred PSC. Primary endpoints were time intervals (door-to-puncture, onset-to-puncture, door-to-door) favorable outcome (mRS ≤ 2) at 90 days. Secondary outcomes successful recanalization, mortality rate, symptomatic intracranial hemorrhage (sICH). Additional analysis was performed not treated EVT; intervals, outcomes, reason exclusion EVT. Results Among total 405 patients, 272 admitted directly 133 transferred; there no significant difference groups occluded vascular territory, baseline NIHSS, wake-up strokes, or thrombolysis rate. Directly had shorter door-to-puncture than (190 min vs. 293 min, p < 0.001). median door-to-door shift 204 min. found functional independence, recanalization rates, sICH rates. exclude angiographic improvement (55.6% patients). Conclusion Our results show that transferring does affect despite expected delay Reassessment upon arrival CSC crucial, patient selection should be done based on both tissue window.