Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment
Purpose Procedure time (PT), defined as the time between groin access and vessel recanalization, is a recently recognized predictor of outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). However, the factors affecting PT and its potential value as a performance measure of...
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Korean Society of Interventional Neuroradiology
2025-07-01
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| Series: | Neurointervention |
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| Online Access: | http://neurointervention.org/upload/pdf/neuroint-2025-00178.pdf |
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| author | Eung-Joon Lee Han-Yeong Jeong Jayoun Kim Nan Hee Park Min Kyoung Kang Dongwhane Lee Jinkwon Kim Yo Han Jung Sungwook Yu Wook-Joo Kim Han-Jin Cho Kyungbok Lee Tai Hwan Park Mi Sun Oh Ji Sung Lee Joon-Tae Kim Byung-Woo Yoon Jong-Moo Park Hee-Joon Bae Keun-Hwa Jung |
| author_facet | Eung-Joon Lee Han-Yeong Jeong Jayoun Kim Nan Hee Park Min Kyoung Kang Dongwhane Lee Jinkwon Kim Yo Han Jung Sungwook Yu Wook-Joo Kim Han-Jin Cho Kyungbok Lee Tai Hwan Park Mi Sun Oh Ji Sung Lee Joon-Tae Kim Byung-Woo Yoon Jong-Moo Park Hee-Joon Bae Keun-Hwa Jung |
| author_sort | Eung-Joon Lee |
| collection | DOAJ |
| description | Purpose Procedure time (PT), defined as the time between groin access and vessel recanalization, is a recently recognized predictor of outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). However, the factors affecting PT and its potential value as a performance measure of AIS treatment remain unexplored. Materials and Methods Using the Korean Stroke Registry, we compared patients who underwent EVT for AIS from 2018 to 2022 based on 60 minutes PT. We conducted multivariate analysis to investigate whether PT <60 minutes was associated with successful recanalization and good functional stroke outcomes. We also investigated factors that independently predicted PT ≥60 minutes. Furthermore, we determined the cutoff point for PT. Results We analyzed 4,703 patients (mean age: 69.5±11.9, 60.3% male) who underwent EVT. The mean PT was 54.6±36.7 minutes. Multivariate analysis revealed that PT <60 minutes independently predicted a good functional outcome as represented by modified Rankin Scale scores of 0–2 (adjusted odds ratio [aOR]: 1.40, 95% confidence interval [CI]: 1.22–1.59). PT <60 minutes was significantly associated with successful recanalization after adjusting for confounding variables (aOR: 1.66, 95% CI: 1.33–2.07). Moreover, after adjusting for covariates, age≥65 years (aOR: 1.20, 95% CI: 1.05–1.38), onset-to-door time (aOR: 1.03, 95% CI: 1.01–1.04), door-to-puncture time (aOR: 1.05, 95% CI: 1.03–1.06), posterior circulation stroke (PCS) (aOR: 1.13, 95% CI: 1.02–1.28), and smoking (aOR: 1.24, 95%CI: 1.09–1.45) independently predicted PT ≥60 minutes. Finally, the highest aOR for good stroke outcome was observed in the 60-minute cutoff model (aOR: 1.45, 95%CI: 1.27–1.67). Conclusion PT <60 minutes was significantly associated with good functional outcomes. Conversely, PT ≥60 minutes was associated with older age, PCS, smoking, prolonged onset-to-door and door-to-puncture time. Further studies are necessary to develop refining strategies for optimizing PT to improve stroke outcomes. |
| format | Article |
| id | doaj-art-d80006c970ed4b4e8bf7fdd8e9ffffac |
| institution | OA Journals |
| issn | 2093-9043 2233-6273 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Korean Society of Interventional Neuroradiology |
| record_format | Article |
| series | Neurointervention |
| spelling | doaj-art-d80006c970ed4b4e8bf7fdd8e9ffffac2025-08-20T02:35:47ZengKorean Society of Interventional NeuroradiologyNeurointervention2093-90432233-62732025-07-01202718110.5469/neuroint.2025.00178460Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke TreatmentEung-Joon Lee0Han-Yeong Jeong1Jayoun Kim2Nan Hee Park3Min Kyoung Kang4Dongwhane Lee5Jinkwon Kim6Yo Han Jung7Sungwook Yu8Wook-Joo Kim9Han-Jin Cho10Kyungbok Lee11Tai Hwan Park12Mi Sun Oh13Ji Sung Lee14Joon-Tae Kim15Byung-Woo Yoon16Jong-Moo Park17Hee-Joon Bae18Keun-Hwa Jung19 Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul Chuk Hospital, Seoul, Korea Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea Department of Neurology, Gangnam Severance Hospital, Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea Department of Neurology, Korea University Medical Center, Seoul, Korea Department of Neurology, Ulsan University Hospital, Ulsan, Korea Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea Department of Neurology, Soon Chun Hyang University Seoul Hospital, Seoul, Korea Department of Neurology, Seoul Medical Center, Seoul, Korea Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea Clinical Research Center, Asan Medical Center, Seoul, Korea Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaPurpose Procedure time (PT), defined as the time between groin access and vessel recanalization, is a recently recognized predictor of outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). However, the factors affecting PT and its potential value as a performance measure of AIS treatment remain unexplored. Materials and Methods Using the Korean Stroke Registry, we compared patients who underwent EVT for AIS from 2018 to 2022 based on 60 minutes PT. We conducted multivariate analysis to investigate whether PT <60 minutes was associated with successful recanalization and good functional stroke outcomes. We also investigated factors that independently predicted PT ≥60 minutes. Furthermore, we determined the cutoff point for PT. Results We analyzed 4,703 patients (mean age: 69.5±11.9, 60.3% male) who underwent EVT. The mean PT was 54.6±36.7 minutes. Multivariate analysis revealed that PT <60 minutes independently predicted a good functional outcome as represented by modified Rankin Scale scores of 0–2 (adjusted odds ratio [aOR]: 1.40, 95% confidence interval [CI]: 1.22–1.59). PT <60 minutes was significantly associated with successful recanalization after adjusting for confounding variables (aOR: 1.66, 95% CI: 1.33–2.07). Moreover, after adjusting for covariates, age≥65 years (aOR: 1.20, 95% CI: 1.05–1.38), onset-to-door time (aOR: 1.03, 95% CI: 1.01–1.04), door-to-puncture time (aOR: 1.05, 95% CI: 1.03–1.06), posterior circulation stroke (PCS) (aOR: 1.13, 95% CI: 1.02–1.28), and smoking (aOR: 1.24, 95%CI: 1.09–1.45) independently predicted PT ≥60 minutes. Finally, the highest aOR for good stroke outcome was observed in the 60-minute cutoff model (aOR: 1.45, 95%CI: 1.27–1.67). Conclusion PT <60 minutes was significantly associated with good functional outcomes. Conversely, PT ≥60 minutes was associated with older age, PCS, smoking, prolonged onset-to-door and door-to-puncture time. Further studies are necessary to develop refining strategies for optimizing PT to improve stroke outcomes.http://neurointervention.org/upload/pdf/neuroint-2025-00178.pdfischemic strokeoperative timeregistriesthrombectomy |
| spellingShingle | Eung-Joon Lee Han-Yeong Jeong Jayoun Kim Nan Hee Park Min Kyoung Kang Dongwhane Lee Jinkwon Kim Yo Han Jung Sungwook Yu Wook-Joo Kim Han-Jin Cho Kyungbok Lee Tai Hwan Park Mi Sun Oh Ji Sung Lee Joon-Tae Kim Byung-Woo Yoon Jong-Moo Park Hee-Joon Bae Keun-Hwa Jung Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment Neurointervention ischemic stroke operative time registries thrombectomy |
| title | Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment |
| title_full | Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment |
| title_fullStr | Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment |
| title_full_unstemmed | Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment |
| title_short | Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment |
| title_sort | procedure time of endovascular thrombectomy as performance measure of acute stroke treatment |
| topic | ischemic stroke operative time registries thrombectomy |
| url | http://neurointervention.org/upload/pdf/neuroint-2025-00178.pdf |
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