Thrombectomy-capable vs. comprehensive stroke centers: impact on endovascular therapy outcomes in acute large vessel occlusion.

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurological Sciences Pub Date : 2025-10-07 DOI:10.1007/s10072-025-08571-3

Shujuan Gan, Tingyu Yi, Jintao Chen, Wenli Zhang, Yanmin Wu, Meihua Wu, Weifeng Huang, Ya Shao, Lihua Xu, Dongsheng Ju, Liqun Jiao, Wenhuo Chen

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引用次数: 0

Abstract

Background: Although data on the outcomes of endovascular therapy (EVT) for acute ischemic stroke in different stroke centers are limited, this study aimed to evaluate EVT quality and outcomes in thrombectomy-capable stroke centers (TSCs) versus comprehensive stroke centers (CSCs) for ischemic stroke patients with large vessel occlusion.

Materials and methods: This study included 37 stroke centers (11 CSCs, 26 TSCs) dispersed across 20 provinces. Patients with acute anterior circulation large vessel occlusion within 24 hours of symptom onset were enrolled. Regression models were used to control for baseline characteristics and time metrics to assess outcomes by center type.

Results: A total of 947 patients (423 from TSCs, 524 from CSCs; median age: 69 years; 585 [61.8%] men) who underwent EVT were analyzed. Functional independence (modified Rankin Scale score [mRS] 0-2 at 90 days) was 43.5% in TSCs and 49% in CSCs (adjusted odds ratio [aOR], 1.02; 95% CI, 0.693-1.5). Compared to TSCs, CSCs exhibited lower mortality (aOR, 0.466; 95% CI, 0.284-0.767) and higher rates of successful reperfusion (aOR, 3.29; 95% CI, 1.76-6.15). No significant differences were found in terms of symptomatic intracranial hemorrhage or procedural complications. Sensitivity and subgroup analyses supported these findings.

Conclusions: In patients with anterior circulation large vessel occlusion undergoing EVT, CSCs had similar functional independence rates to TSCs but lower mortality and better reperfusion without higher hemorrhage risk.

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血栓切除术与综合卒中中心：对急性大血管闭塞患者血管内治疗结果的影响。

背景：尽管不同脑卒中中心对急性缺血性脑卒中的血管内治疗（EVT）结果的数据有限，但本研究旨在评估具有血栓切除术能力的脑卒中中心（TSCs）与综合脑卒中中心（CSCs）对缺血性脑卒中大血管闭塞患者的EVT质量和结果。材料和方法：本研究包括分布在20个省份的37个卒中中心（11个csc， 26个tsc）。患者急性前循环大血管闭塞24小时内出现症状。回归模型用于控制基线特征和时间指标，以评估中心类型的结果。结果：共分析947例EVT患者(423例来自TSCs， 524例来自CSCs，中位年龄：69岁，585例（61.8%）男性。功能独立性（90天时修正Rankin量表评分[mRS] 0-2）在TSCs中为43.5%，在CSCs中为49%（调整优势比[aOR]， 1.02; 95% CI, 0.693-1.5）。与TSCs相比，CSCs的死亡率较低（aOR, 0.466; 95% CI, 0.274 -0.767），再灌注成功率较高（aOR, 3.29; 95% CI, 1.76-6.15）。在症状性颅内出血或手术并发症方面，两组无显著差异。敏感性和亚组分析支持这些发现。结论：在接受EVT的前循环大血管闭塞患者中，CSCs与TSCs具有相似的功能独立性，但死亡率更低，再灌注更好，且无更高的出血风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurological Sciences 医学-临床神经学

CiteScore

6.10

自引率

3.00%

发文量

743

审稿时长

4 months

期刊介绍： Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.