Endovascular therapy has revolutionized acute stroke management associated with large vessel occlusions (LVO). The province of Saskatchewan currently has 8 primary stroke centres (PSC) and 1 comprehensive stroke centre (CSC) spread over a large geographical area. Seventy three percent of the population lives outside the Saskatoon metropolitan area, which houses the province’s single comprehensive stroke centre. In an effort to decrease treatment disparities, the Saskatchewan acute stroke pathway worked in conjunction with all PSC’s to ensure best practice delivery of stroke services. Despite this, geography remains a significant barrier to providing endovascular therapy in a timely manner to eligible patients, knowing that the time to recanalization is a vital variable in clinical outcome. In a retrospective analysis of acute stroke patients with LVOs in Saskatchewan from July 2016-February 2018, 52 patients were transferred from PSCs to the CSC for possible endovascular therapy. 71% no longer qualified for thrombectomy, due to clinical improvement, recanalization seen on CTA, or progression of stroke with low Aspects score upon reassessment at the CSC. Inter-facility deterioration risk factors were assessed using transfer metrics, patient characteristics, and initial imaging findings at the PSC to understand this patient population better.

Factors Affecting Qualification for Thrombectomy at a Comprehensive Stroke Center Following Inter Facility Transfer