Performance evolution over 645 acute stroke thrombectomies in a public Brazilian healthcare institution

Int J Stroke. 2021 Oct;16(8):927-934. doi: 10.1177/1747493020968435. Epub 2020 Oct 29.

Abstract

Background: Assessment of the impact of the thrombectomy learning curve on clinical outcomes is essential for developing healthcare system protocols.

Aims: The aim of this study was to assess the effect of thrombectomy case volume on procedural and clinical outcomes in a Brazilian registry.

Methods: A total of 645 patients with acute ischemic stroke treated by thrombectomy were included in the analysis. Patients were divided into two groups regarding the period of treatment: the early period group and the late period group.

Results: In the adjusted analysis, treatment in the late period was an independent predictor of recanalization (odds ratio 1.91, 95% CI 1.28-2.86) and excellent neurologic outcomes at three months (odds ratio 1.77, 95% CI 1.04-3.01). Treatment in the late period had no significant association with mortality (odds ratio 0.88, 95% CI 0.55-1.41).

Conclusions: An increase in thrombectomy case volume for the treatment of AIS over time was an independent predictor of recanalization and excellent neurologic outcome.

Keywords: Thrombectomy; acute ischemic stroke; large vessel occlusion; learning curve; recanalization; volume of procedures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Ischemia* / surgery
  • Delivery of Health Care
  • Endovascular Procedures*
  • Humans
  • Retrospective Studies
  • Stroke* / surgery
  • Thrombectomy
  • Treatment Outcome