One-Stop Management Improves Outcome for Large Vessel Occlusion Stroke

Area of Science:

• Neurology
• Interventional Radiology
• Emergency Medicine

Background:

• Mechanical thrombectomy (MT) is crucial for large vessel occlusion (LVO) stroke outcomes.
• Treatment delays significantly impact functional recovery.
• Comparing direct angiosuite transfer (OSM) versus conventional CT protocols is essential.

Purpose of the Study:

• To compare the efficacy of the one-stop management (OSM) approach versus conventional treatment for LVO stroke.
• To evaluate the impact of OSM on procedural times and patient functional outcomes.

Main Methods:

• An observational study of 205 acute ischemic stroke patients (NIHSS ≥7, onset ≤4.5 hours) treated with OSM.
• Comparison with 2470 patients from the German Stroke Registry using conventional methods.
• Propensity score matching was used to control for confounding variables.
• Primary endpoints included door-to-groin and door-to-reperfusion times, NIHSS, and modified Rankin Scale at 90 days.

Main Results:

• OSM significantly reduced door-to-groin (33.33 vs 95.73 min) and door-to-reperfusion (78.06 vs 147.47 min) times (P<0.001).
• OSM patients demonstrated greater NIHSS improvement.
• Improved modified Rankin Scale at 90 days was observed in the OSM group (OR, 2.26; P<0.05).

Conclusions:

• Direct angiosuite transfer (OSM) for LVO stroke treatment shortens procedural times.
• The OSM approach is associated with improved functional outcomes compared to conventional methods.
• OSM represents a more efficient strategy for LVO stroke management.