Objective: Mechanical thrombectomy (MT) improves clinical outcome in acute ischemic stroke (AIS) patients. The effect of MT over the outcome of these patients is time sensitive. The onset nature of AIS is abrupt and unpredictable. Therefore, the temporal variation of onset of AIS requires a well-organized stroke chain infrastructure to minimize its impact on the clinical outcome. The term “weekend effect” has also been reported in the field of AIS. MT as a multi-disciplinary treatment requires optimal coordination of workflow and manpower to overcome the “weekend effect.”
Materials and
Methods: We retrospectively analyzed data from our prospective stroke center registry. Clinical, radiological, time-metrics, and outcome of patients who underwent MT from January to December 2023 were analyzed. The patients included in this study were divided into a daytime, nighttime, weekend, and holiday groups. Main outcome variables included favorable outcome (modified Rankin scale scores of 0–2) 3 months post-stroke as well as procedural time metrics (door-angio). Variation between subgroups was statistically analyzed.

Results: A total of 371 patients were compatible with the inclusion criteria. The median age was 68 (±12.9) years and the median onset National Institutes of Health Stroke Scale score 17. Detailed time-metrics analysis showed that radiology to puncture and door to puncture time were significantly lower during working hours compared to other non-working hours. No significant difference was found between working hours and nighttime, weekend, or holiday hour regarding time-metrics for both transfer and mothership patients (p>0.001).

Conclusion: Overall, analysis of the present data showed short time-metrics regardless of temporal variation. These findings emphasize the role of in hospital organization. In addition, our stroke flow organization model may encourage the building of similar models.