Introduction With the clear Class I, Level of Evidence A indication that thrombectomy for acute stroke is beneficial, the intervention community must, along with the refinement of thrombectomy techniques, work to improve patient triage and workflow. Comprehensive stroke center (CSC) are now at risk of saturation due to augmented patient admission load.
Hypothesis Mechanical thrombectomy (MT) on an outpatient basis may be a solution to avoid congestion in CSC. The question is to determine if MT on an outpatient basis is as safe and effective as conventional hospitalization.
Methods Based on our prospectively gathered database we extracted patients who were admitted for MT for anterior circulation ischemic strokes in our CSC since 2012. Due to practical reasons of organization and workflow, many of these patients were readdressed to the referring stroke centers immediately or within 24 hours after mechanical thrombectomy. We dichotomized patients for which the stay was <24 h (outpatients) and those whose stay was >24 h (inpatients) and compared their characteristics and outcomes.
Results The baseline characteristics of both groups are detailed in Table 1. Both patient groups were comparable for gender, lateralization of occlusion, intravenous lysis prior to MT, time elapsed from stroke onset to femoral puncture, quality of reperfusion. Outpatients were older but with lower NIHSS at admission, had more frequently isolated MCA than carotid siphon/MCA or tandem occlusions, better DWI-ASPECTS, less often general anesthesia, less procedural complications and better functional outcomes at 3 month.
Conclusions MT on an outpatient basis is safe and feasible.
Disclosures M. Piotin: 2; C; Medtronic, Stryker, Penumbra, Microvention, Balt. H. Redjem: None. G. Ciccio: None. S. Smajada: None. R. Blanc: 2; C; Medtronic, Stryker, Penumbra, Microvention, Balt.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.