14th World Stroke Congress, Singapore, 26-29 October 2022

Background and Aims: Access to emergent mechanical thrombectomy (MT) for acute ischemic stroke with large vessel occlusions is limited worldwide with vast disparities between countries. MT2020+, a global initiative of SVIN, aimed to create a global MT access score using systematic, mixed methods approach performed to objectively measure the drivers of access needed to accelerate treatment worldwide. Methods: Four independent investigators performed an in-depth systematic literature review using the Peer Review of Electronic Search Strategies. Access drivers were identified and categorized into 3 groups: information and diagnostic access, physical access and financial access. A multispecialty international expert panel was created and scored each attribute using a modified Delphi process with assistance of University of Calgary W21C. A 1-9-point scale was used, with 1 being not at all important and 9 being extremely important, followed by virtual face to face meeting to deliberate attributes whose mean fell between 4-6. Results: After initial screening of 2864 abstracts, 523 studies were included in the final systematic review. A total of 34 possible attributes that drive access were identified. After the modified Delphi process, 26 individual attributes were determined to be of significance in the creation of a MT access score. 5 attributes were related to financial access, 11 were related to physical access and 10 were information and diagnostic drivers of access. Conclusions: The global MT access score represents a tool to evaluate MT access barriers in different world regions. Weighting of the individual attributes and validation of the score will be needed prior to its implementation.