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Differences in Performance on Quality Measures for Thrombectomy-Capable Stroke Centers Compared With Comprehensive
David W Baker1, Stephen Schmaltz1, Karen Kolbusz1
1The Joint Commission Oakbrook Terrace IL.
Stroke (Hoboken, N.J.)
|January 26, 2026
Summary
Thrombectomy-Capable Stroke Centers (TSCs) showed longer times for mechanical thrombectomy (MT) than Comprehensive Stroke Centers (CSCs), but this gap narrowed. Quality of MT and complication rates were similar, supporting TSC use when CSCs are further away.
Area of Science:
- Neurology
- Vascular Surgery
- Health Services Research
Background:
- Thrombectomy-Capable Stroke Center (TSC) certification aims to improve mechanical thrombectomy (MT) access.
- No prior studies compared MT quality at TSCs versus Comprehensive Stroke Centers (CSCs).
Purpose of the Study:
- To compare the quality of mechanical thrombectomy (MT) and stroke care between Thrombectomy-Capable Stroke Centers (TSCs) and Comprehensive Stroke Centers (CSCs).
Main Methods:
- Performance was compared for 3 MT measures (time to puncture, reperfusion rates, symptomatic hemorrhage) in 2019 and 2020.
- Statistical analysis included Wilcoxon ranked-sum and signed-rank tests.
Main Results:
- Median time from arrival to skin puncture was longer at TSCs (106.1 min in 2019, 91.7 min in 2020) compared to CSCs (75.8 min in 2019, 74.8 min in 2020).
- The time difference between TSCs and CSCs narrowed significantly in 2020.
- Rates of successful reperfusion (Thrombolysis in Cerebral Infarction ≥2B) and symptomatic hemorrhagic complications were similar between TSCs and CSCs.
Conclusions:
- Longer MT times at TSCs improved, with similar outcomes and complication rates compared to CSCs.
- Current recommendations to transport large-vessel occlusion patients to TSCs if CSCs are >30 minutes farther are supported.
- Local routing decisions should consider TSC and CSC performance data.
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