Performance evolution over 645 acute stroke thrombectomies in a public Brazilian healthcare institution

Abstract

Background: Assessment of the impact of the thrombectomy learning curve on clinical outcomes is essential for developing healthcare system protocols.

Aims: The aim of this study was to assess the effect of thrombectomy case volume on procedural and clinical outcomes in a Brazilian registry.

Methods: A total of 645 patients with acute ischemic stroke treated by thrombectomy were included in the analysis. Patients were divided into two groups regarding the period of treatment: the early period group and the late period group.

Results: In the adjusted analysis, treatment in the late period was an independent predictor of recanalization (odds ratio 1.91, 95% CI 1.28-2.86) and excellent neurologic outcomes at three months (odds ratio 1.77, 95% CI 1.04-3.01). Treatment in the late period had no significant association with mortality (odds ratio 0.88, 95% CI 0.55-1.41).

Conclusions: An increase in thrombectomy case volume for the treatment of AIS over time was an independent predictor of recanalization and excellent neurologic outcome.

Keywords: Thrombectomy; acute ischemic stroke; large vessel occlusion; learning curve; recanalization; volume of procedures.