Introduction Acute ischemic stroke (AIS) is an acute impairment of brain function caused by a central nervous system focal injury of a vascular origin. Major issue is the applicability of RCTs results achieved in the well-organized centers and in a highly-controlled settings, compared to a real-world situation, especially in developing country medical systems which are dealing with lack of trained personnel, shortage of appropriate financial and material support, lower basic health level of the population, etc.

Case Description This double center observational cohort study with the pragmatic care trial context for AIS patients treated with MT included data from 284 patients at Toulouse University prospective stroke registry and data from 82 patients at The Clinical Center of Serbia prospective stroke registry. Clinical and radiological data collection of treated cases were from January 2015 to January 2017 at Toulouse University center, and from January 2018 to January 2020 at The Clinical Center of Serbia.

Results (Overall rate of good clinical outcome (mRS 0-2) and mortality rate (mRS 6) were 49% and 18.3%, respectively. Compared to previously conducted RCTs, the overall higher mortality rate observed in the Belgrade cohort is due to the cohort exhibiting a significantly higher rate of mRS 6 at three months compared to the Toulouse cohort sample (15.1% vs. 29.3 respectively). The higher mortality in the Belgrade cohort sample is consistent with the results of the studies done in other middle-income and low-income countries.

Disclosure of Interest no.