A multicenter analysis of "time to microcatheter" for endovascular therapy in acute ischemic stroke

Abstract

Purpose: At present, no time recommendation for initiation of endovascular treatment in acute ischemic stroke is available. A multicenter analysis was designed to identify variables that prolong "time to microcatheter," defined as the time interval from computed tomographic scan to microcatheter placement in the cerebral circulation.

Methods: Consecutive acute ischemic stroke patients from 3 academic stroke centers were included. Analysis of covariance was used to evaluate different variables that prolong "time to microcatheter."

Results: Ninety-one patients underwent emergent endovascular treatment for acute ischemic stroke. Mean "time to microcatheter" was 174±60 minutes. No significant time difference was found in patients who were intubated, presented at night or weekends, were administered intravenous recombinant tissue plasminogen activator, or underwent additional imaging prior to endovascular treatment. "Time to microcatheter" was significantly longer in nonlevel I trauma centers and in patients with National Institutes of Health Stroke Scale Score of 10 to 19.

Conclusion: Wide variability of "time to microcatheter" among institutions highlights the need for standardized time goals.