Closing the gap: Early experience from a new Endovascular Thrombectomy service in regional and rural North Queensland, Australia

BACKGROUND: Endovascular clot retrieval is the standard of care for acute ischemic stroke caused by large vessel occlusion. However, access to mechanical thrombectomy remains limited in rural and regional areas, where patients often require transfer to urban centres. These delays are directly associated with poorer clinical outcomes. To address this disparity, a mechanical thrombectomy service was established at a regional tertiary hospital in North Queensland, Australia. This study aims to evaluate the safety and clinical outcomes of mechanical thrombectomy in a regional setting. METHODS: A retrospective analysis was conducted on all consecutive patients who underwent mechanical thrombectomy at Townsville University Hospital (TUH), Queensland, Australia, between March 2022 and February 2024. Patients were categorized into two groups-local (TUH) and interhospital transfer-based on their initial presentation. Clinical outcomes, procedural success, and complications were assessed. RESULTS: A total of 120 patients (mean age: 71 years; 51 % male) underwent mechanical thrombectomy. Of these, 48 (40 %) presented locally, while 72 (60 %) were interhospital transfers. A good functional outcome (mRS 0-2 at 90 days) was achieved in 56 patients (47 %). Procedural success (mTICI score 2b-3) was observed in 106 patients (88 %), while 14 patients (12 %) experienced procedure-related complications. CONCLUSION: The establishment of a mechanical thrombectomy service at TUH has significantly improved access to stroke intervention for regional and rural populations in North Queensland. Our early experience demonstrates clinical outcomes comparable to those reported in large multicentre thrombectomy trials, confirming the feasibility and safety of delivering this service in a regional setting.