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4 - DOES SECONDARY TRANSFER FOR THROMBECTOMY IMPACT SIGNIFICANTLY THE OUTCOME OF PATIENTS? RESULTS OF A RETROSPECTIVE OBSERVATIONAL STUDY OF 622 CONSECUTIVE PATIENTS FROM BEGIAN HOSPITALS NETWORKS

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ESOC-2019

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Abstract

Background and Aims: Endovascular thrombectomy in acute ischaemic stroke with proximal occlusion is recognized as the best treatment. It is not known if the patients should be referred directly to the Comprehensive Stroke Center (CSC) or to the nearest Primary Stroke Center (PSC) first. Methods: We reviewed 622 consecutive acute stroke patients treated by thrombectomy between 2015 and 2017. Each network consists in a CSC and several PSC far of less than 100 kilometers. We considered 6 predictive factors: age, NIHSS on admission, transfer, delay between stroke onset to emergency admission, IV thrombolysis before thrombectomy, delay between symptoms and to recanalization time. Results: There was a mean delay of 42 minutes between admission to emergencies and recanalization for patients who bypass the PSC (CSC=107 min, PSC = 149 min; p < 0.001). Good outcome (modified Rankin Score less or equal to 2) did not differ significantly at 3 month of follow up (44,6% in the group from CSC and 53,4% in the group from PSC, p = 0.12). Stepwise logistic regression analysis revealed that iv thrombolysis before thrombectomy is a good predictive factor (p<0.001). Conclusions: In hospitals networks where the distances between PSC and CSC are less than 100 km and the delay of thrombectomy does not exceed 45 min, drip & ship has no negative impact on the mRS at 3 months. The only predictive factor of good outcome was iv thrombolysis performed before thrombectomy.

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© Copyright 2019 Morressier GmbH.
All rights reserved.