Introduction Mechanical thrombectomy (MT) is typically performed by experienced neurointerventional radiologists. However, logistical and geographic limitations often hinder access to rapid MT, especially in remote areas.

Aim of Study To explore the use of remote teleproctoring to support MT conducted by general interventional radiologists (IR) at thrombectomy capable centers, compared to on-site proctoring outcomes.

Methods The Arnau de Vilanova Hospital in Spain, serving 500,000 people over 12,000 km², used to transfer stroke patients requiring MT to a comprehensive stroke center 160 km away. To overcome COVID-19 mobility restrictions, the Tegus Teleproctoring System was installed. From April 2021 to May 2023, general IR conducted MT either with on-site proctor supervision or teleproctoring support. We aim to compare clinical outcome of patients receiving MT according to proctoring method

Results During the study, 51 MTs were performed: 17 with TEGUS teleproctoring and 34 with on-site proctoring. Both groups had similar baseline characteristics, except for NIHSS scores (Tegus 9 (IQR 6-20) v/s 18 (IQR 12-22), p: 0,034). No significant differences were found in door-to-revascularization time (82 (SD 28.2) v/s 84 (SD 26.4) min, p: 0.895). The final mTICI distribution and 90-day mRS scores were comparable. There were no reports of symptomatic intracranial hemorrhage in either group.

Conclusion This study shows the feasibility of remote teleproctoring during emergent cases of MT in a remote hospital. It could improve the learning curve of interventional radiologists with limited experience in MT, and lower the territorial inequity associated to MT.

Disclosure of Interest no.