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Original research
Efficacy of ‘drive and retrieve’ as a cooperative method for prompt endovascular treatment for acute ischemic stroke
  1. Toshiya Osanai1,
  2. Yasuhiro Ito1,
  3. Satoshi Ushikoshi2,
  4. Takeshi Aoki3,
  5. Masahito Kawabori1,
  6. Kensuke Fujiwara4,
  7. Katsuhiko Ogasawara5,
  8. Kikutaro Tokairin1,
  9. Katsuhiko Maruichi6,
  10. Naoki Nakayama1,
  11. Ken Kazumata1,
  12. Kota Ono7,
  13. Kiyohiro Houkin1
  1. 1 Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
  2. 2 Department of Neurosurgery, Hokkaido Medical Center, Sapporo, Japan
  3. 3 Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan
  4. 4 Department of Radiological Science, Faculty of Health Sciences, Japan Health Care College, Sapporo, Japan
  5. 5 Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
  6. 6 Department of Neurosurgery, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
  7. 7 Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
  1. Correspondence to Dr Toshiya Osanai, Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 0608638, Japan; osanait{at}


Background Outcomes of endovascular treatment for acute ischemic stroke depend on the time interval from onset to reperfusion. Although the centralized ‘mothership’ method is considered preferable, the required transportation time increases the risk that a patient with a stroke may not receive intravenous or endovascular therapy. In contrast, ‘drive and retrieve’ describes a system wherein doctors from comprehensive stroke centers travel to primary stroke centers and provide endovascular treatment for acute ischemic stroke.

Objective To describe the drive and retrieve system and verify the effects of this new collaboration on outcomes in patients with acute ischemic stroke among facilities.

Methods This non-randomized, single-arm study retrospectively analyzed patients who met the inclusion criteria for endovascular treatment provided through a drive and retrieve system. Among the 122 patients treated by this system, we analyzed the time of onset to recanalization as the primary outcome. We also analyzed the efficacy of the drive and retrieve system using geographic information system analysis.

Results The median time from onset to recanalization was 229 min (IQR 170–307 min, 95% CI 201 to 252 min). The upper limit of the 95% CI for the time from onset to recanalization was shorter than the median times reported in two previous trials. Geographic information system analysis revealed an upward trend in the population coverage rate in each secondary medical area after the drive and retrieve method was introduced.

Conclusion The drive and retrieve method may be an effective form of cooperation between facilities located within 1 hour of a comprehensive stroke center.

  • thrombectomy
  • stroke
  • intervention

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  • Contributors All authors have made substantial contributions to the conception or design of the work and the acquisition, analysis, and interpretation of data for the work. All authors helped in drafting the work and revising it critically. All authors worked on the final approval of the submitted version and all authors agree on all aspects of the work to ensure accuracy and integrity of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.