Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Impact of a newly opened mechanical thrombectomy center on stroke management: volume, delays, and clinical outcomes.
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Trouille Océane, Veunac Louis, Berge Jérôme, Tourdias Thomas, Marnat Gaultier, Bourgeois-Beauvais Quentin
Аннотация
BACKGROUND AND PURPOSE: Expanding mechanical thrombectomy (MT) capacity through new thrombectomy-capable stroke centers (TSC) may increase MT utilization and reduce treatment delays. We evaluated the impact of a newly opened TSC on MT volume, delays, and clinical outcomes in France.
MATERIALS AND METHODS: We retrospectively analyzed data from two prospective stroke databases (Bordeaux and Bayonne). We included patients presenting to Bayonne with ischemic stroke who were transferred to Bordeaux for MT (Drip-and-Ship, DS) before TSC opening, and patients presenting to and treated at Bayonne after on-site MT availability (mothership, MS), from March 2015 to February 2023. We compared MT volume, treatment delays, procedural outcomes, safety, and 90-day functional outcomes between the two groups.
RESULTS: Among 272 patients, 82 (30.1%) were treated under DS (before March 2019) and 190 (69.9%) under MS. Annual MT volume tripled from ∼ 20 to 60 in the first year after TSC opening. Median onset-to-puncture time was significantly shorter in MS (198 min, IQR 158-248) versus DS (335 min, IQR 280-375; p < 0.001). Recanalization rates (mTICI 2b-3: aOR 0.82, 95%CI 0.34-2.01; mTICI 3: aOR 0.80, 95%CI 0.42-1.52) and procedural complications (aOR 2.15, 95%CI 0.74-6.29) were comparable. MS patients showed greater early NIHSS improvement (-3.02, 95%CI - 5.35 to - 0.70; p = 0.011), with a non-significant trend toward better 90-day outcomes (p = 0.19).
CONCLUSIONS: A newly opened TSC significantly increased MT volume, reduced treatment delays, and improved early neurological outcomes while preserving safety, supporting further evaluation of expanded MT territorial coverage to reduce geographic disparities in stroke care.
MATERIALS AND METHODS: We retrospectively analyzed data from two prospective stroke databases (Bordeaux and Bayonne). We included patients presenting to Bayonne with ischemic stroke who were transferred to Bordeaux for MT (Drip-and-Ship, DS) before TSC opening, and patients presenting to and treated at Bayonne after on-site MT availability (mothership, MS), from March 2015 to February 2023. We compared MT volume, treatment delays, procedural outcomes, safety, and 90-day functional outcomes between the two groups.
RESULTS: Among 272 patients, 82 (30.1%) were treated under DS (before March 2019) and 190 (69.9%) under MS. Annual MT volume tripled from ∼ 20 to 60 in the first year after TSC opening. Median onset-to-puncture time was significantly shorter in MS (198 min, IQR 158-248) versus DS (335 min, IQR 280-375; p < 0.001). Recanalization rates (mTICI 2b-3: aOR 0.82, 95%CI 0.34-2.01; mTICI 3: aOR 0.80, 95%CI 0.42-1.52) and procedural complications (aOR 2.15, 95%CI 0.74-6.29) were comparable. MS patients showed greater early NIHSS improvement (-3.02, 95%CI - 5.35 to - 0.70; p = 0.011), with a non-significant trend toward better 90-day outcomes (p = 0.19).
CONCLUSIONS: A newly opened TSC significantly increased MT volume, reduced treatment delays, and improved early neurological outcomes while preserving safety, supporting further evaluation of expanded MT territorial coverage to reduce geographic disparities in stroke care.