The impact of interhospital transfer on patients undergoing endovascular thrombectomy for acute ischemic stroke from a comprehensive stroke center.

Background: Patients with acute stroke frequently require transfer to a comprehensive stroke center (CSC) for endovascular thrombectomy (EVT). We studied the impact of the transfer on functional outcomes for acute ischemic stroke caused by large vessel occlusion (LVO).

Methods: We conducted a retrospective analysis using data from a prospective stroke registry on patients who underwent EVT for LVO between January 2019 and June 2024 at a CSC.

Results: Three hundred and seventy-six of seven hundred seventy three patients were transferred to the CSC and were significantly younger (67.4 ± 15.2 vs. 71.7 ± 15.0, p-value = 0.0002). No significant differences were observed in baseline characteristics, including gender, admission National Institutes of Health Stroke Scale (NIHSS), and the rate of intravenous thrombolysis between the two groups. The time from symptom onset to groin puncture was significantly longer for the transfer group (690.1 min vs. 486.0 min, p < 0.0001). The time of symptom onset to reperfusion time was also longer for the transfer group (713.3 min vs. 521.8 min, p < 0.0001). The groin puncture to reperfusion time (39.0 min vs. 36.8 min, p = 0.2183), and door-in to reperfusion time (312 min vs. 223.3 min, p = 0.0731), were comparable between the two cohorts. Likewise, the rates of successful reperfusion TICI grade ≥2B, symptomatic intracranial hemorrhage (sICH), discharge to home, and in-hospital mortality were similar between the two groups (all p > 0.05).

Conclusion: Despite significantly longer time intervals from symptom onset to the initiation of mechanical thrombectomy in transfer patients, there were no adverse consequences on prognosis.