Bypass of Primary Stroke Centers Compared With Secondary Transfer for Endovascular Thrombectomy

Background Our stroke network operates a hybrid organizational structure, with patients potential large‐vessel occlusion taken to the local primary center (PSC) during office hours, and directly bypassed endovascular thrombectomy–capable (EVT‐SC) after hours. We aimed compare 2 methods of transfer. Methods Consecutive anterior treated EVT between August 2017 February 2021 were identified. Patients who had puncture within 6 hours last known normal included for analysis. grouped into method presentation: direct bypass EVT‐SC (“EVT‐SC direct”) or PSC secondary transfer (“PSC‐transfer”). The outcome was 3‐month functional independence (modified Rankin scale score 0–2). Secondary outcomes mortality at 7 days 3 months. Results A total 259 (109 women; mean±SD age, 66.8±15.2 years) included; there 91 (35.1%) 168 (64.9%) PSC‐transfer patients. shorter median times from thrombolysis (120 versus 147 minutes; P =0.004) (190 230 <0.001). Multivariable logistic regression analysis found that greater (odds ratio [OR], 2.04 [95% CI, 1.12–3.73]; =0.02) lower (OR, 0.33 0.12–0.91]; =0.03). For every 100 EVT‐SC, 14 more functionally independent 9 fewer died, Conclusions In this comparison paradigms in as closest center, resulted significantly better process clinical compared transfers PSCs.