Evidence map›Paper›PMID 40668465›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025

Enlarged therapeutic window for ischemic stroke in a real life regional experience: is it always a valid approach?

Giovanna Viticchi, Silvia Paolucci, Chiara Di Felice, Marco Bartolini, Gianluca Moroncini, Mauro Silvestrini, Lorenzo Falsetti

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Giovanna ViticchiNeurological Clinic, Experimental and Clinical Medicine Department, Marche Polytechnic University, Via Conca 1, Ancona, 60020, Italy. g.viticchi@staff.univpm.it.ORCID http://orcid.org/0000-0002-1799-1563
Silvia PaolucciNeurological Clinic, Experimental and Clinical Medicine Department, Marche Polytechnic University, Via Conca 1, Ancona, 60020, Italy.
Chiara Di FeliceNeurological Clinic, Experimental and Clinical Medicine Department, Marche Polytechnic University, Via Conca 1, Ancona, 60020, Italy.
Marco BartoliniNeurological Clinic, Experimental and Clinical Medicine Department, Marche Polytechnic University, Via Conca 1, Ancona, 60020, Italy.
Gianluca MoronciniClinica Medica, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
Mauro SilvestriniNeurological Clinic, Experimental and Clinical Medicine Department, Marche Polytechnic University, Via Conca 1, Ancona, 60020, Italy.
Lorenzo FalsettiClinica Medica, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternational trials suggested the efficacy of therapeutic window enlarged for mechanical thrombectomy (MT) in acute ischemic stroke (AIS). Real-life studies seem to confirm this opportunity. We aimed to evaluate the therapeutic window enlargement impact in an about 1.5 million residents region to determine if our drip-and-ship organization could ensure favorable clinical outcome and safety for patients treated more than 6 h after stroke onset.

methodsAll AIS patients attending the Emergency Department of the only Marche region hub hospital who underwent MT were enrolled. We collected epidemiological, clinical and radiological variables. We used the National Institutes of Health Stroke Scale (NIHSS) to assess patients and calculated delta (NIHSS) as the difference between admission and discharge NIHSS scores. We examined patients undergoing MT with an onset-to-groin time (OGT) of less and greater than 6 h.

resultsDelta (NIHSS) showed a statistically significant difference between patients who underwent MT within and after 6 h from symptom onset, with notable improvement in the first group. The overall prevalence of post-procedural intracranial bleeding did not significantly differ between the two groups (32.3% vs. 38.2%; p = 0.266). The risk of in-hospital deaths significantly increased among patients treated after 6 h.

conclusionsOur results suggest satisfactory AIS outcomes even when treated several hours after the symptoms' onset, despite a significant increase in the number of in-hospital deaths. However, the better results obtained with earlier IT and MT confirm the "golden hour" concept. Our findings show that our stroke organization provides a good clinical opportunity for patients treated within an extended therapeutic window.

Indexed as

Ischemic StrokeThrombectomyTime-to-TreatmentAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexTime FactorsTreatment OutcomeStrokeStroke netTherapeutical windowThrombectomy

Identifiers

PMID40668465

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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.