Key result
Off-hour thrombectomy shows no difference in reperfusion agreement or functional outcomes vs normal hours.
Why the study?
It was uncertain whether site-reported eTICI scores differ from core lab assessments during off hours compared with normal hours and whether outcomes differ by procedure timing.
Do thrombectomy procedures performed during off hours have worse clinical outcomes or different core-lab vs site-reported eTICI score agreement compared to normal hours?
Observational (n=1,318)
Do thrombectomy procedures performed during off hours have worse clinical outcomes or different core-lab vs site-reported eTICI score agreement compared to normal hours?
Absolute Event Rate: 86.1% vs 87.2%
Clinical outcomes and the reliability of site-reported reperfusion grading do not significantly differ for stroke thrombectomy performed during off hours versus normal hours.
BACKGROUND: Data from the ASSIST registry were analyzed to assess whether site-reported expanded Treatment in Cerebral Infarction (eTICI) scores differ from those reported by the core lab during off hours compared with normal hours. We also assessed whether outcomes are worse in procedures performed during off hours. METHODS: Details from the registry have been previously published. Regression models were performed for first-pass treatment of target occlusion resulting in ≥2c by the core lab, agreement for final pass ≥2c, modified Rankin Scale 0 to 2 at 90 days, and whether first-pass eTICI ≥2c agreed between the core lab and site-reported assessments. RESULTS: A total of 1318 patients were included. Overall, agreement between core-lab and site-reported eTICI for first-pass eTICI ≥2c occurred in 86.7% and 78.5% for final eTICI ≥2c. Agreement for first-pass and final-pass eTICI ≥2c occurred in 87.2% and 77.7% during normal hours and 86.1% and 79.3% during off hours. Good functional outcomes occurred in 55.5% of patients presenting during normal hours and 53.8% of patients presenting during off hours. Off-hour versus normal-hour procedures were not significantly associated with first-pass efficacy, modified Rankin Scale 0 to 2 at 90 days, or whether first-pass eTICI agreed between the core lab and site-reported assessments in adjusted regression analyses. CONCLUSIONS: There was a higher level of agreement between core-lab and site-reported first-pass eTICI scores during all hours, while agreement occurred less often for final reperfusion. These results suggest a high level of correlation regardless of the time of the procedure between site-adjudicated and core-lab-adjudicated successful reperfusion grading. There were no significant differences in outcomes irrespective of the timing of thrombectomy. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03845491.
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Dandapat et al. (2026) conducted an observational in Ischemic stroke (n=1,318). Off-hour procedures vs. Normal-hour procedures was evaluated on Agreement between core-lab and site-reported assessments for first-pass eTICI ≥2c. Off-hour thrombectomy procedures compared with normal-hour procedures showed no significant differences in first-pass eTICI ≥2c score agreement (86.1% vs 87.2%) or 90-day functional outcomes (53.8% vs 55.5%).
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