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January 22, 2026European Stroke JournalOpen Access

Association between door-to-needle time and outcomes in acute ischemic stroke patients treated with intravenous thrombolysis plus mechanical thrombectomy: Analysis from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS)

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Authors

VSValentina SaiaAMAlfredo Paolo MascoloFMFederico Marrama

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Overview

Analysis shows shorter door-to-needle time improves outcomes in acute ischemic stroke patients treated with IVT and MT, indicating treatment efficiency is crucial.

Key Points

  • To evaluate how door-to-needle time affects outcomes in acute ischemic stroke patients treated with intravenous thrombolysis and mechanical thrombectomy.
  • Analyzed data from the IRETAS registry.
  • Included patients with AIS due to specific artery occlusions.
  • Evaluated association between DTN and outcomes using logistic regression analyses.
  • Used pre-defined DTN cut-off values of ⩽30, ⩽45, and ⩽60 minutes.
  • DTN ⩽ 60 min associated with increased three-month functional independence (OR 1.36).
  • Shorter DTNs linked to successful reperfusion: ⩽30 min (OR 2.66), ⩽45 min (OR 1.68), ⩽60 min (OR 1.57).
  • DTN ⩽ 60 min correlated with reduced intracranial hemorrhage rates (OR 0.61).
  • Shorter DTNs led to lower three-month mortality: ⩽30 min (OR 0.24), ⩽45 min (OR 0.45), ⩽60 min (OR 0.58).

Cite This Study

Saia et al. (2026) studied this question.

synapsesocial.com/papers/6971bdcf642b1836717e280ahttps://doi.org/10.1093/esj/23969873251368720
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Abstract TP002: Door-to-Reperfusion Time Is More Strongly Associated with Poor Outcomes Than Onset-to-Door Time in Mechanical Thrombectomy for Acute Ischemic Stroke2026
  2. 2ABSTRACT NUMBER: ESOC2026A2022 ASSOCIATION OF ULTRAFAST THROMBOLYSIS WITH EARLY NEUROLOGICAL OUTCOME IN ACUTE ISCHEMIC STROKE2026
  3. 3ABSTRACT NUMBER: ESOC2026A1751 TRENDS IN DOOR-TO-NEEDLE TIME FOLLOWING EXPANSION OF THROMBOLYSIS INDICATIONS IN ACUTE ISCHAEMIC STROKE2026
  4. 4Decomposing door-to-needle time: insights into workflow delays and quality improvement in acute stroke care2025 · 2 citations
  5. 5Bridging the Gap: Improving Acute Ischemic Stroke Outcomes with Intravenous Thrombolysis Prior to Mechanical Thrombectomy2024