Endovascular therapy for large ischemic stroke in directly admitted versus transferred patients: A secondary analysis

BACKGROUND: Endovascular therapy (EVT) has been proved beneficial in patients with acute large vessel occlusion (LVO) with large infarcts, but it is unknown whether the benefit would be affected by the interhospital-transfer status. We investigated the efficacy of EVT according to the interhospital-transfer status in such patients. METHODS: This was a secondary analysis of the ANGEL-ASPECT trial. Patients with acute anterior-circulation LVO and large infarcts, defined by Alberta stroke program early CT score (ASPECTS) 3-5 or infarct core volume 70-100 mL, were enrolled from 46 centers across China and randomized (1:1) to receive EVT with medical management (MM) versus MM alone. We dichotomized patients into two subgroups based on whether admitted directly to the EVT-capable center or transferred from a primary center. The primary outcome was the 90-day modified Rankin Scale (mRS). RESULTS: for interaction = 0.706). CONCLUSIONS: In acute anterior-circulation LVO patients with large infarcts, the benefit of EVT compared to MM did not vary by the interhospital-transfer status.