Faculty of Medicine

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    Item type:Publication,
    IMPACT OF TIME-TO-TREATMENT AND THROMBECTOMY TECHNIQUE ON OUTCOMESINACUTEISCHEMICSTROKE:ASINGLE-CENTERCOHORTANALYSIS
    (Macedonian Association of Anatomists and Morphologists, 2025-06)
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    Introduction:Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO). Time-to-reperfusion is the most critical determinant of patient outcome. This study aimed to conduct a comprehensive analysis of key time metrics and the efficacy of MT at our institution, evaluating their impact on both angiographic and clinical results to identify areas for process optimization.Methods:We conducted a retrospective analysis of a cohort of 17 consecutive patients treated with MT for LVO stroke. We analyzed demographics, baseline clinical status (mRS), occlusion location, detailed time-to-treatment intervals, procedural techniques, and outcomes. The primary angiographic endpoint was successful reperfusion, defined as an extended Thrombolysis in Cerebral Infarction (eTICI) score of ≥2b. Clinical endpoints included functional outcome at 3 months, measured by the mRS, and the rate of symptomatic intracranial hemorrhage (sICH).Results:The mean patient age was 60.9 years, with a significant male predominance (70.6%). All patients presented with severe stroke (initial mRS 4-5), indicating a high-acuity cohort. The mean time from symptom onset to final reperfusion was prolonged at 505 minutes (8 hours 25 minutes). Despite this, a high rate of successful reperfusion (eTICI ≥2b) was achieved in 85.7% of patients, with complete reperfusion (eTICI ≥2c/3) in 57.1%. However, this technical success did not fully translate to clinical recovery, as a good functional outcome (mRS 0-2) at 3 months was achieved in only 30.8% of patients. The rate of sICH was 15.4%.Conclusion:Our center achieves high rates of technical success in reperfusion (85.7% eTICI ≥2b), comparable to international benchmarks. However, prolonged treatment delays are significantly attenuating clinical outcomes, with only 30.8% of patients achieving functional independence. This analysis underscores that procedural excellence alone is insufficient; optimizing system-wide time-to-treatment protocols isthe critical next step to improve patient recovery.