Observational studyCirculation2017
Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke).
Observational study in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02239640 (Systematic Evaluation of Patients Treated With Stroke Devices for Acute Ischemic Stroke), which is not on this map. Cited by 210 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Systematic Evaluation of Patients Treated With Stroke Devices for Acute Ischemic Stroke (STRATIS) Registry
Who cites it
210 citing papers in PubMed, 9 syntheses or guidelines pooled it, 408 citations in OpenAlex.
- Intravenous thrombolysis use before interhospital transfer for thrombectomy: a systematic review and meta-analysis.Journal of neurology · 2026Pooled it
- Latest evidence on transfer efficiency and patient outcomes in mothership versus drip-and-ship models for acute stroke management: a systematic review and meta-analysis.Frontiers in neurology · 2026Pooled it
- Bridging thrombolysis versus direct thrombectomy in acute ischemic stroke with large vessel occlusion: a network meta-analysis.Journal of neurology · 2025Pooled it
- Prehospital Large-Vessel Occlusion Stroke Detection Scales: A Pooled Individual Patient Data Analysis of 2 Prospective Cohorts.Neurology · 2025Pooled it
- Success with incrementally faster times to endovascular therapy (SWIFT-EVT): A systematic review and meta-analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2024Pooled it
- Mechanical thrombectomy combined with intravenous thrombolysis for acute ischemic stroke: a systematic review and meta-analyses.Scientific reports · 2023Pooled it
- IV Thrombolysis Initiated Before Transfer for Endovascular Stroke Thrombectomy: A Systematic Review and Meta-analysis.Neurology · 2023Pooled it
- Direct admission versus secondary transfer for acute ischemic stroke patients treated with thrombectomy: a systematic review and meta-analysis.Journal of neurology · 2021Pooled it
- Comparison of Prior Bridging Intravenous Thrombolysis With Direct Endovascular Thrombectomy for Anterior Circulation Large Vessel Occlusion: Systematic Review and Meta-Analysis.Frontiers in neurology · 2021Pooled it
- One-year functional outcome of the Flying Intervention Team versus patient interhospital transfer in acute ischaemic stroke.European stroke journal · 2026Trial
- Trial
- Relationship between primary stroke center volume and time to endovascular thrombectomy in acute ischemic stroke.European journal of neurology · 2021Trial
- Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy.PloS one · 2021Trial
- Long-term implementation of a prehospital severity scale for EMS triage of acute stroke: a real-world experience.Journal of neurointerventional surgery · 2020Trial
- Use, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States.Circulation · 2019Trial
- Clinical Utility of Circulating Biomarkers for Diagnosis and Prognosis of Acute Stroke in the Emergency Department: A Narrative Review from Current Evidence to Clinical Implementation.Diagnostics (Basel, Switzerland) · 2026Review
- Rendezvous transport plus prehospital computed tomography angiography on mobile stroke unit for large vessel occlusion: Achieving 103 min call-to-puncture time in 106 km distance.Journal of telemedicine and telecare · 2026Article
- Blood-Brain Barrier Disruption Before Interhospital Transfer for Thrombectomy and Clinical Outcome.Neurology · 2026Article
- In vitro comparison of manual and robotic endovascular thrombectomy for acute ischemic stroke.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Prehospital Detection of Large Vessel Occlusion and Intracerebral Hemorrhage Using a Dual-Biomarker Point-of-Care Test.Stroke (Hoboken, N.J.) · 2026Article
150 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
65 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation.
methodsSTRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke because of anterior-circulation large-vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours. Patients underwent MT with or without intravenous tissue plasminogen activator and were admitted to endovascular-capable centers via either interhospital transfer or direct presentation. The primary clinical outcome was functional independence (modified Rankin Score 0-2) at 90 days. We assessed (1) real-world time metrics of stroke care delivery, (2) outcome differences between direct and transfer patients undergoing MT, and (3) the potential impact of local hospital bypass.
resultsA total of 984 patients were analyzed. Median onset-to-revascularization time was 202.0 minutes for direct versus 311.5 minutes for transfer patients (
conclusionsIn this large, real-world study, interhospital transfer was associated with significant treatment delays and lower chance of good outcome. Strategies to facilitate more rapid identification of large-vessel occlusion and direct routing to endovascular-capable centers for patients with severe stroke may improve outcomes. CLINICAL
trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT02239640.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.