Abstract Number: Esoc2026a1459 Outcomes of Mechanical Thrombectomy and Intravenous Thrombolysis in Acute Ischemic Stroke: A Retrospective Cohort Study From St. Luke's Hospital Kilkenny, 2022–2025

Abstract Background and aims Acute ischemic stroke remains a leading cause of mortality. Reperfusion therapies have transformed acute stroke management. To evaluate clinical characteristics, treatment patterns, and in-hospital outcomes among acute ischemic stroke patients receiving mechanical thrombectomy, intravenous thrombolysis, or combined therapy at a regional stroke center in Ireland. Methods A retrospective cohort study of acute ischemic stroke admissions at St. Luke's Hospital was conducted from Jan 1, 2022, till Sep 30, 2025. Data were extracted from the Hospital In-Patient Enquiry reporting database. Patients were stratified by reperfusion treatment: mechanical thrombectomy alone, intravenous thrombolysis alone, combined therapy, or no reperfusion therapy. Primary outcomes included demographics, comorbidities, length of hospital stay, and in-hospital complications. Results 663 patients with acute Ischameic Stroke were included (mean age 73.1 ± 13.7 years; 57.5% male), 19 (2.9%) received mechanical thrombectomy, 23 (3.5%) received intravenous thrombolysis, 10 (1.5%) received combined therapy, and 611 (92.2%) received no reperfusion treatment. Patients receiving mechanical thrombectomy alone were younger (67.8 ± 10.3 years) and predominantly male (78.9%). Combined therapy patients were oldest (78.0 ± 9.4 years) with highest atrial fibrillation prevalence (60.0%). Hemorrhagic transformation occurred in 26.3% of thrombectomy-alone patients, 13.0% of thrombolysis-alone patients, and 20.0% of combined-therapy patients. Conclusions At this regional Irish stroke center, reperfusion therapy utilization remained low (7.8% overall), reflecting patient selection, transfer logistics, and contraindications. Patients receiving reperfusion therapies demonstrated distinct clinical profiles, with hemorrhagic transformation rates consistent with published literature. These findings highlight opportunities to optimize stroke systems of care and expand access to evidence-based reperfusion strategies. Conflict of interest Mohammad Bilal Khan Nothing to disclose