Observational studyJournal of the American Heart Association2026
Direct Transport to a Thrombectomy Center Accelerates Acute Stroke Reperfusion Therapies in Nonurban Settings.
Observational study in Journal of the American Heart Association, 2026. 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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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.
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Authors and funding
14 authors.
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Abstract
backgroundIn the United States, the impact of bypassing the nearest local stroke center to facilitate direct transport of nonurban patients to a thrombectomy-capable center (TCC) for mechanical thrombectomy (MT) remains unclear. We compared intravenous thrombolysis and MT treatment times between patients transferred directly to a TCC and those transported initially to a local stroke center and undergoing MT.
methodsIn this retrospective observational study within an academic health care system with integrated telestroke and transport services, we included consecutive nonurban patients (ground transport ≥15 minutes to TCC) who were transported via emergency medical services and underwent MT between January 2021 and October 2024. Patients were categorized into those transported directly to TCC or those initially taken to 1 of 12 telestroke-supported local stroke centers and subsequently transferred to TCC. These groups were compared using inverse probability of treatment weighting. Outcomes included first medical contact-to-intravenous thrombolysis, first medical contact-to-arterial puncture, and first medical contact-to-arrival times, among others. All times are expressed as median (IQR).
resultsAmong 304 patients (transported directly to TCC, 174; initial transport to local stroke center, 130; median age, 72 [IQR, 62-82] years; median National Institutes of Health Stroke Scale score, 16 [IQR, 12-22]; 36.5% air transported), first medical contact-to-intravenous thrombolysis (75 [IQR, 65-89] versus 86 [IQR, 72-110] minutes;
conclusionsAmong nonurban patients undergoing MT, direct transport to a TCC accelerated treatment times and may improve clinical outcomes. Our study highlights inefficiencies in regional systems of care.
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