Abstract 101: Direct Transfer To Angiosuite Versus Ct Scanner On Arrival To Endovascular Capable Centers; More Risks Or More Benefits

Abstract

Background and Objectives: Endovascular therapy (EVT) is standard treatment for large vessel occlusion strokes. To reduce inter-hospital times, most patients are usually transferred directly to the angio suite (DTAS) but some transfers are initially taken to the CT scanner (DTCT) to re-evaluate. The objective of our study is to compare outcomes in patients DTAS vs DTCT. Methods: This is retrospective study of LVO stroke from 2017 to 2021 transferred to our CSS from outside hospitals for mechanical thrombectomy (MT). Recruitment was done from the University of Toledo/Promedica stroke database and specific variables were included from chart review. Patients were divided into two cohorts, DTAS and DTCT. Results were calculated with SPSS software. Results: Total of 246 patients were transferred from an outside hospital for MT, 55.6% patients were DTAS vs 44.3% patients to DTCT. There was no significant difference between basic demographics. In both groups, most common vessels involved were M1 (38.4% vs 39.4%), followed by M2 (25.4% vs 29.4%) then ICA terminus (19.6% vs 16.5%). DTAS had significant shorter door to puncture time (35 vs 62 mins, p=0.03), onset to recanalization time (346 vs 583 mins, p=0.012) and onset to groin puncture (329 vs 557 mins, p<0.01). There was no statistically significant difference in puncture to recanalization between two groups (35.6 vs 22.8, p=0.05). Successful MT (mTICI ≥2b) was more in DTAS vs DTCT (91.9% vs 86.9%, p=0.02). At discharge, DTAS group had more decrement in NIHSS, compared to presentation and discharge (Δ13, NIHSS 18.1 to 5) compared to DTCT group (Δ9, NIHSS 16 to 7). Both groups had statistically non-significant rates of functional dependence at discharge (mRS 0-2, 18% vs 13%, p=0.23), at 90 days (mRS 0-2, 35% vs 36%) and mortality at 90 days (34% vs 36%, p=0.56). Rate of complications in DTAS vs DTCT, hemorrhagic transformation (29.1% vs 23.9%, p=0.23) and intracranial hemorrhage (5.2% vs 8.3%, p=0.54) was not significant. Conclusion Our study concluded that DTAS has better reperfusion rates, time matrices and decrement of NIHSS compared to DTCT. Functional outcomes at discharge, 90 days and mortality at 90 days was not significantly difference between two groups.