Background and Aims

BACKGROUND AND PURPOSE: Mechanical Thrombectomy (MT) is

standard of care for patients presenting with acute ischemic stroke due to large vessel

occlusion. We report main clinical outcomes of patients receiving MT

Methods

METHODS: Retrospective analysis of prospectively collected stroke database of patients receiving MT at our comprehensive stroke centre (CSC) – ”direct-to-mothership” model versus transferred from twenty-one primary stroke centres (PSC) – ”drip-and-ship” model; serving 46,153 km² in Queensland, Australia between January 2015 and December 2018

Results

RESULTS: Out of 187, 103 (55%) presented directly to the CSC versus 84 (45%) transferred from PSCs. The transfer group demonstrated a longer median time from symptom-onset to groin puncture (354, IQR: 229-452 mins, p<0.001) compared to the direct group (216, IQR: 145-275 mins). 90-day functional independence defined as modified Rankin Scale 0-2 (61.1% vs 61.9%), 90-day mortality (22.3% vs 20.2%), successful recanalization defined as Thrombolysis in Cerebral Infarction Score 2b-3 (88.3% vs 86.9%) or any hemorrhagic transformation (22.5% vs 25.0%) were similar in both groups (p>0.05). Subgroup analysis of transferred patients demonstrated reduced odds of achieving 90-day functional independence (OR: 0.989, CI: 0.980-0.998, p<0.02) and increased odds of 90-day mortality (OR:1.009, CI:1.002-1.015, p<0.02) with increasing distance and door-to-door times respectively, between the PSC and CSC.

Conclusions

CONCLUSION: Our twenty-two-centre network experience confirms real world reproducibility of trial results and similar functional outcomes in both models.