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E-282 Direct to angiosuite strategy versus standard workflow triage for endovascular therapy: systematic review and meta-analysis
Abstract   Open access   Peer reviewed

E-282 Direct to angiosuite strategy versus standard workflow triage for endovascular therapy: systematic review and meta-analysis

M Galecio-Castillo, J Vivanco-Suarez, C Zevallos, A Dajles, J Weng, M Ribo, M Farooqui, T Jovin and S Ortega-Gutierrez
Journal of neurointerventional surgery, Vol.14(Suppl 1), pp.A232-A232
07/23/2022
DOI: 10.1136/neurintsurg-2022-SNIS.393
url
https://doi.org/10.1136/neurintsurg-2022-SNIS.393View
Published (Version of record) Open Access

Abstract

Introduction/PurposeReducing stroke workflow time metrics when performing mechanical thrombectomy (MT) in stroke patients with suspected large vessel occlusion (LVO) has shown an association with improved clinical outcomes. We performed a systematic review and meta-analysis to compare safety and efficacy outcomes between a direct to angiosuite (DTAS) and a standard workflow (SW) strategy among stroke patients with suspected LVO who underwent MT.Materials and MethodsWe performed a comprehensive literature search in Medline, Embase, and Web of Science databases between 2015 and 2021. Observational studies and clinical trials that compared DTAS versus SW strategy were assessed, all the studies where at least one outcome of interest was reported were included. The risk of bias was evaluated in all the included publications. We compared the rates of functional outcomes, reperfusion times, symptomatic intracranial hemorrhage, and stroke workflow metrics. Clinical, methodological, and statistical heterogeneity were measured. A random-effects model was used.ResultsTwelve studies were included in the systematic review and eight in the meta-analysis with 2890 patients. The DTAS strategy was associated with higher odds of good functional outcome at 90-days (47.3% vs. 34.9%; Odds ratio [OR]: 1.58; 95% confidence interval [CI]: 1.16–2.14) and an average reduction in door-to-puncture time in minutes (mean differences [MD]: -35.09; 95% CI: -49.76 to -20.41]) and door-to reperfusion time in minutes (MD: -32.88; 95% CI: -50.75 to -15.01). There was no significant difference in symptomatic intracranial hemorrhage (OR: 0.80; 95% CI: 0.53–1.20), mortality (OR: 1.00; 95% CI: 0.60–1.67), or successful reperfusion rates (OR: 1.59; 95% CI: 0.99–2.56]). Moreover, the DTAS was associated with greater odds of dramatic clinical improvement at 24 hours (OR: 1.79; 95% CI: 1.15–2.79).ConclusionPatients who underwent the DTAS strategy had a significant reduction in door-to-puncture and door-to- reperfusion times. These time reductions resulted in an increased rate of early neurological and 90-day functional recovery without compromising safety in LVO patients undergoing MT.Disclosures M. Galecio-Castillo: None. J. Vivanco-Suarez: None. C. Zevallos: None. A. Dajles: None. J. Weng: None. M. Ribo: 2; C; Anaconda Biomed, Apta Targets, Medtronic, Stryker, Cerenovus, Philips, Ischemia View. 4; C; Anaconda Biomed, Methinks. M. Farooqui: None. T. Jovin: 1; C; Stryker Neurovascular. 2; C; Anaconda Biomed, VizAI, FreeOX Biotech, Corindus, Cerenovus, Route92, Blockade Medical, Medtronic. S. Ortega-Gutierrez: 2; C; Medtronic, Stryker.
 SNIS 19th annual meeting electronic poster abstracts

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