Efficacy of stroke bypass for mechanical thrombectomy with large vessel occlusion scale(FACE₂AD) in Atami-Ito area

Abstract

Background: In all, 66.7% of the mechanical thrombectomy (MT) cases were transferred between hospitals in the Atami-Ito medical area. The stroke bypass protocol with the FACE₂AD scale (3 points for cutoff and within 6 hours or unknown onset) for LVO had been deployed since September 2018 (Atami-Ito stroke bypass for LVO:AISB for LVO). Methods: (1) In all, 49 cases underwent MT from June 2015 to April 2020 before and after AISB deployment. (2) In all, 54 patients were directly transported by AISB, and positive predictive value of LVO and increase in the number of emergency transportations were analyzed. Result: (1) The transfer rate between hospitals had significantly decreased from 66.7% to 27.3% (P=0.03). (2) The positive predictive value of our protocol for LVO was 55%. The increase in the number of cases directly transported to hospitals capable of MT was 1.28/month on average. Conclusions: AISB significantly decreased the transfer rate of MT patients between hospitals in the Atami-Ito medical area. The increase in the number of emergency transportations was only 1.28/month.