In-hospital Ischemic Stroke Treated by Mechanical Thrombectomy

Area of Science:

• Neurology
• Interventional Neurology
• Public Health

Background:

• In-hospital stroke (IHS) presents unique challenges compared to out-of-hospital stroke (OHS).
• Mechanical thrombectomy is a critical treatment for acute ischemic stroke.

Purpose of the Study:

• To compare the characteristics, treatment, and outcomes of IHS versus OHS patients treated with mechanical thrombectomy.
• To identify areas for improvement in the management of IHS.

Main Methods:

• Retrospective comparison of 19 IHS patients and 154 OHS patients undergoing mechanical thrombectomy.
• Analysis of patient demographics, stroke severity, treatment times, reperfusion success, and clinical outcomes at 90 days.

Main Results:

• IHS patients experienced significantly longer times from detection to imaging and puncture, but shorter times from puncture to reperfusion.
• Successful reperfusion rates (TICI 2b-3) and 90-day favorable outcomes (modified Rankin Scale 0-2) were comparable between IHS and OHS groups.
• IHS patients had a lower rate of intravenous tissue plasminogen activator (IV-tPA) use and no symptomatic procedural complications, versus 7.1% in OHS.

Conclusions:

• Despite longer initial diagnostic delays, mechanical thrombectomy in IHS patients achieved rapid reperfusion with outcomes similar to OHS patients.
• Optimizing rapid stroke pathways and specialist consultation for IHS is recommended to improve treatment efficiency.