Abstract TMP48: Effects Of Telestroke On Endovascular Therapy Timeliness And Outcomes

Abstract

Backgrounds: Telestroke is associated with improved reperfusion and improved outcomes for stroke patients. Our objective was to examine the effect of telestroke on procedural timeliness and outcomes among patients transferred for endovascular therapy (EVT). Methods: We identified all EVT encounters at our urban, telestroke-enabled, academic comprehensive stroke center (CSC) from 1/1/2017 to 12/31/2020 in our institutional Get With The Guidelines-Stroke registry linked with our telestroke consultation records. EVT encounters were categorized based on mode of arrival: i) transferred via the telestroke network (Tx+TS), ii) transferred without telestroke (Tx-TS), or iii) directly presenting to the CSC (DP). The three groups were then compared on efficacy and safety measurements including first-pass rate, successful reperfusion (TICI 2b/3) and post-procedure complications, as well as mortality and functional independence (mRS ≤ 2) outcomes both at discharge and 90-day post discharge using multi-group testing. Results: After excluding 29 encounters with unknown arrival mode, our sample of 287 EVT encounters included 168 Tx+TS cases, 35 Tx-TS cases, and 84 DP cases. Patients’ demographics and baseline characteristics (NIHSS at admission and prior comorbidities) were balanced across the groups (Table). Compared to both Tx-TS and DP, Tx+TS has significantly shorter door to puncture time (Tx+TS: 30 mins vs. Tx-TS: 62 mins vs. DP: 92 mins, p < 0.001). Procedural efficacy and safety, in-hospital outcomes and post discharge outcomes were similar across groups. Conclusion: Our study demonstrates that telestroke plays an important role among patients transferred for EVT with improved procedural timeliness, and outcomes similar to those of directly presenting patients.