BACKGROUND: EVT is recommended as standard of care in Canada. However, there is limited data about its effectiveness in routine practice. We compared patient outcomes after EVT versus routine medical care in Halifax, the only centre performing EVT in the province of Nova Scotia. 

Methods:  Using our prospective stroke registry (maintained since 1997), we identified all patients who underwent EVT after our participation in the ESCAPE trial between Feb 1, 2013 until Jan 31, 2017, and matched them in a hierarchical fashion with control patients who did not receive EVT based on age (5 years), pre-hospital functional status, stroke syndrome, severity, and thrombolysis administration. Demographics, in-hospital mortality, discharge disposition from acute care, and length of stay in hospital (including rehabilitation) were compared between cases and controls.  

Results:  We identified 45 cases and 45 controls. 51% of the cases and 57% of the controls were female. We demonstrated a statistically significant reduction in in-hospital mortality, favouring intervention with EVT n=5 (22.7%) compared to n=17 (77.3%) (P = 0.006). Of the survivors, cases’ median length of stay in acute care was 13 days (range 2-105), which was shorter compared to the controls’ 20 days (range 2-149) (P =0.239). Similarly, median length of stay in hospital for cases was 37 days shorter than controls (P = 0.54). Patients who received EVT were also more likely to be discharged home from acute care 13 (57.5%) compared to controls 9 (32.1%) (P=0.05). 

Conclusion: EVT significantly reduced in-hospital mortality post-stroke. There were nonsignificant trends in favour of EVT for discharge home from acute care, and length of stay in hospital, including in-patient rehabilitation.

ENDOVASCULAR THROMBECTOMY (EVT) FOR STROKE: EFFECTIVENESS IN ROUTINE PRACTICE IN A CANADIAN TEACHING CENTRE